Therapists in Johnson City, TN

Photo of Laura Maxwell, Licensed Psychoanalyst in Johnson City, TN
Laura Maxwell
Licensed Psychoanalyst, LPC/MHS
Not Verified Not Verified
Johnson City, TN 37601
Laura Maxwell is a psychotherapist licensed to practice in Tennessee and Virginia. She holds a Master of Arts in Counseling from East Tennessee State University and a Master of Education from West Texas A&M University. She has experience working in various clinical settings, including community mental health, higher education, inpatient and private practice.
Laura Maxwell is a psychotherapist licensed to practice in Tennessee and Virginia. She holds a Master of Arts in Counseling from East Tennessee State University and a Master of Education from West Texas A&M University. She has experience working in various clinical settings, including community mental health, higher education, inpatient and private practice.
(423) 481-9124 View (423) 481-9124
Photo of Lee Sinnott, Licensed Professional Counselor in Johnson City, TN
Lee Sinnott
Licensed Professional Counselor, LPC
Verified Verified
Johnson City, TN 37604
Lee Sinnott is a Licensed Professional Counselor (LPC) with over 6 years of experience, working with a wide variety of people. He is passionate about helping his clients in those around him to find their personal power and developing skills to live a life of their own, making in line with their goals and dreams.
Lee Sinnott is a Licensed Professional Counselor (LPC) with over 6 years of experience, working with a wide variety of people. He is passionate about helping his clients in those around him to find their personal power and developing skills to live a life of their own, making in line with their goals and dreams.
(423) 561-9574 View (423) 561-9574
Photo of Alynda Worrell-Welch, Pre-Licensed Professional in Johnson City, TN
Alynda Worrell-Welch
Pre-Licensed Professional, LPCMHSP, (TEMP)
Verified Verified
3 Endorsed
Johnson City, TN 37601
I understand counseling as a process that helps people grow into fuller, deeper, and healthier ways of engaging with themselves and the world they live in. I specialize in working with children, adolescents, young adults, and their families through depression, anxiety, and significant life changes. I am especially passionate about issues that impact women and LGBTQ+ folks, and strive to find points of connection with all my clients.
I understand counseling as a process that helps people grow into fuller, deeper, and healthier ways of engaging with themselves and the world they live in. I specialize in working with children, adolescents, young adults, and their families through depression, anxiety, and significant life changes. I am especially passionate about issues that impact women and LGBTQ+ folks, and strive to find points of connection with all my clients.
(423) 799-3909 View (423) 799-3909
Photo of Katherine Barteck, Psychologist in Johnson City, TN
Katherine Barteck
Psychologist, PsyD
Verified Verified
Johnson City, TN 37601
I provide individual therapy, to adolescents and adults, as well as couples and family therapy. I believe that the focus of therapy is the achievement of insight and both intra- and inter-personal growth. This means different things to different people and families, so I actively involve you in the direction of your therapy and will check in often to make sure that your needs are being met. I trained as a generalist and pull from a variety of therapeutic approaches, including interpersonal process, insight-oriented, and cognitive-behavioral.
I provide individual therapy, to adolescents and adults, as well as couples and family therapy. I believe that the focus of therapy is the achievement of insight and both intra- and inter-personal growth. This means different things to different people and families, so I actively involve you in the direction of your therapy and will check in often to make sure that your needs are being met. I trained as a generalist and pull from a variety of therapeutic approaches, including interpersonal process, insight-oriented, and cognitive-behavioral.
(423) 930-9338 View (423) 930-9338
Photo of North Star Counseling LLC, Licensed Professional Counselor in Johnson City, TN
North Star Counseling LLC
Licensed Professional Counselor, LPC, MHSP, CCATP
Verified Verified
Johnson City, TN 37615
I provide therapy to people from all walks of life and tailor counseling to each individual. I meet people right where they are to help them take steps towards the life they want. I believe that people who struggle with their thoughts and feelings are often just looking for a way to be the person they want to be and sometimes get lost along the way. They want to hold true to their personal values when making choices but have trouble finding a way forward. I believe that, through therapy, people can learn new and creative ways to respond to those thoughts and feelings so they can get back to living a life guided by their values.
I provide therapy to people from all walks of life and tailor counseling to each individual. I meet people right where they are to help them take steps towards the life they want. I believe that people who struggle with their thoughts and feelings are often just looking for a way to be the person they want to be and sometimes get lost along the way. They want to hold true to their personal values when making choices but have trouble finding a way forward. I believe that, through therapy, people can learn new and creative ways to respond to those thoughts and feelings so they can get back to living a life guided by their values.
(423) 556-3833 View (423) 556-3833
Photo of Vanessa Civil, Pre-Licensed Professional in Johnson City, TN
Vanessa Civil
Pre-Licensed Professional, MS
Verified Verified
1 Endorsed
Johnson City, TN 37601  (Online Only)
Welcome! I specialize in supporting young adults, and couples through life's transitions, self-discovery, and relationships. My passion lies in empowering individuals to develop independence and nurture a confident identity. For couples, I guide the process of blending two unique identities into a harmonious partnership. I find profound joy in witnessing my clients as they courageously confront challenging emotions, navigate complex behaviors, and nurture healthier relationships. Together, we'll unravel the past, envision the future, and I'll stand by your side, offering empathy and unwavering support every step of the way.
Welcome! I specialize in supporting young adults, and couples through life's transitions, self-discovery, and relationships. My passion lies in empowering individuals to develop independence and nurture a confident identity. For couples, I guide the process of blending two unique identities into a harmonious partnership. I find profound joy in witnessing my clients as they courageously confront challenging emotions, navigate complex behaviors, and nurture healthier relationships. Together, we'll unravel the past, envision the future, and I'll stand by your side, offering empathy and unwavering support every step of the way.
(423) 516-8194 View (423) 516-8194
Photo of Kay Collake, Clinical Social Work/Therapist in Johnson City, TN
Kay Collake
Clinical Social Work/Therapist, LCSW
Verified Verified
Johnson City, TN 37601
Do you find yourself overwhelmed with the competing priorities of daily life? Stuck in unhealthy patterns such as overuse of alcohol, procrastination, or emotional eating? Are your days spent battling perfectionism and negative self-talk? Would you like to be more active socially but struggle with anxiety or feelings of low self-worth? Hi. I’m Kay. Congratulations on taking the first step toward living your best life! I am a Licensed Clinical Social Worker with 15 years of experience providing psychotherapy, assessment, and referral services to adults, children, and families.
Do you find yourself overwhelmed with the competing priorities of daily life? Stuck in unhealthy patterns such as overuse of alcohol, procrastination, or emotional eating? Are your days spent battling perfectionism and negative self-talk? Would you like to be more active socially but struggle with anxiety or feelings of low self-worth? Hi. I’m Kay. Congratulations on taking the first step toward living your best life! I am a Licensed Clinical Social Worker with 15 years of experience providing psychotherapy, assessment, and referral services to adults, children, and families.
(615) 392-6827 View (615) 392-6827
Photo of Jennifer Hasty, Licensed Professional Counselor in Johnson City, TN
Jennifer Hasty
Licensed Professional Counselor, LPC, MHSP
Verified Verified
3 Endorsed
Johnson City, TN 37601
Not accepting new clients
Are you holding deep shame and embarrassment for something in the past that was beyond your control? Maybe you have a need to be in control or have everything perfect; or put others' needs first all the time, suffering from guilt for saying "no". Perhaps you have feelings of worthlessness, struggling with a paralyzing fear of going shopping on a busy day. Maybe physical symptoms like sleep disturbances, gut pain, racing heartbeat? When stress hormones flood your body, you're not working to full potential. Domestic violence, car accidents, sexual assault, childhood abuse, and sudden losses - all can be root causes to you symptoms.
Are you holding deep shame and embarrassment for something in the past that was beyond your control? Maybe you have a need to be in control or have everything perfect; or put others' needs first all the time, suffering from guilt for saying "no". Perhaps you have feelings of worthlessness, struggling with a paralyzing fear of going shopping on a busy day. Maybe physical symptoms like sleep disturbances, gut pain, racing heartbeat? When stress hormones flood your body, you're not working to full potential. Domestic violence, car accidents, sexual assault, childhood abuse, and sudden losses - all can be root causes to you symptoms.
(423) 427-2618 View (423) 427-2618
Photo of Hunter Cook, Licensed Professional Counselor in Johnson City, TN
Hunter Cook
Licensed Professional Counselor, LPC, MHSP
Verified Verified
1 Endorsed
Johnson City, TN 37601
Hunter has worked in a variety of settings including inpatient mental health, adolescent residential, community mental health, as well as providing services to youth in the juvenile justice system. He makes it a priority to work with his client’s to bring out their innate strengths in order to improve their lives. He does so by encouraging acceptance of their current life situation and working towards living in a manner more consistent with the client’s deeply held values of what is important to them.
Hunter has worked in a variety of settings including inpatient mental health, adolescent residential, community mental health, as well as providing services to youth in the juvenile justice system. He makes it a priority to work with his client’s to bring out their innate strengths in order to improve their lives. He does so by encouraging acceptance of their current life situation and working towards living in a manner more consistent with the client’s deeply held values of what is important to them.
(423) 556-9116 View (423) 556-9116
Photo of The Journey Center for Healing Arts, PLLC, Licensed Professional Counselor in Johnson City, TN
The Journey Center for Healing Arts, PLLC
Licensed Professional Counselor, MA, LPCS, FAMI, MT-BC, MHSP
Verified Verified
4 Endorsed
Johnson City, TN 37604
At The Journey Center for Healing Arts, we are passionate about helping people move beyond their past and into a full, authentic life. Trauma affects us all at some level - surviving physical pain, emotional pain, or spiritual pain - and it can keep us from living the life we want. We want to see you thrive through your healing process instead of continuing to struggle with worry, overwhelm, anxiety, depression, grief, and unhealthy relationships.
At The Journey Center for Healing Arts, we are passionate about helping people move beyond their past and into a full, authentic life. Trauma affects us all at some level - surviving physical pain, emotional pain, or spiritual pain - and it can keep us from living the life we want. We want to see you thrive through your healing process instead of continuing to struggle with worry, overwhelm, anxiety, depression, grief, and unhealthy relationships.
(423) 408-8041 View (423) 408-8041
Photo of Ginger Ketron, Clinical Social Work/Therapist in Johnson City, TN
Ginger Ketron
Clinical Social Work/Therapist, LCSW
Verified Verified
Johnson City, TN 37604  (Online Only)
Ginger Ketron is a Licensed Clinical Social Worker with 9 years of experience working with children, adults, couples and families to overcome their unique barriers in life to improve their futures. She works to empower each patient with coping skills. She is passionate in assisting individuals in a family system to increase healthy boundaries and bonds that increase the success of their family. Ginger completed her MSW degree at East Tennessee State University where she was in the Advanced Standing Master's Program. She has worked with children and adults throughout her life who have or are dealing with effects of trauma.
Ginger Ketron is a Licensed Clinical Social Worker with 9 years of experience working with children, adults, couples and families to overcome their unique barriers in life to improve their futures. She works to empower each patient with coping skills. She is passionate in assisting individuals in a family system to increase healthy boundaries and bonds that increase the success of their family. Ginger completed her MSW degree at East Tennessee State University where she was in the Advanced Standing Master's Program. She has worked with children and adults throughout her life who have or are dealing with effects of trauma.
(423) 295-7486 View (423) 295-7486
Photo of Pam Kuykendall, Pre-Licensed Professional in Johnson City, TN
Pam Kuykendall
Pre-Licensed Professional, MA
Verified Verified
Johnson City, TN 37601
Thank you for taking time to view my profile. Being a mental health care provider is a calling and a passion. Healing from the effects of trauma, perinatal and postpartum mental health concerns, anxiety, and depression is possible. The healing journey is different for each person and I will patiently walk alongside my clients each step of the way. I also provide premarital counseling, family therapy, and have experience with parenting assistance and spiritual health.
Thank you for taking time to view my profile. Being a mental health care provider is a calling and a passion. Healing from the effects of trauma, perinatal and postpartum mental health concerns, anxiety, and depression is possible. The healing journey is different for each person and I will patiently walk alongside my clients each step of the way. I also provide premarital counseling, family therapy, and have experience with parenting assistance and spiritual health.
(423) 436-0401 View (423) 436-0401
Photo of Carly Hedrick, Clinical Social Work/Therapist in Johnson City, TN
Carly Hedrick
Clinical Social Work/Therapist, LCSW
Verified Verified
Johnson City, TN 37601
Carly Hedrick is a Licensed Clinical Social Worker in the state of Tennessee. Carly graduated with her Master's degree in Social Work from East Tennessee State University. She also earned a Master's degree in Divinity from Emmanuel Christian Seminary. Carly’s approach to therapy is shaped by past occupational experiences which have taught her to sit with others in painful emotions and stressful circumstances and listen with compassion, curiosity, and acceptance.
Carly Hedrick is a Licensed Clinical Social Worker in the state of Tennessee. Carly graduated with her Master's degree in Social Work from East Tennessee State University. She also earned a Master's degree in Divinity from Emmanuel Christian Seminary. Carly’s approach to therapy is shaped by past occupational experiences which have taught her to sit with others in painful emotions and stressful circumstances and listen with compassion, curiosity, and acceptance.
(423) 482-9816 View (423) 482-9816
Photo of Alyssa Scott, Psychologist in Johnson City, TN
Alyssa Scott
Psychologist, PsyD
Verified Verified
Johnson City, TN 37601
Alyssa Scott is a Psychologist in Tennessee who has been practicing since 2022. She obtained her undergraduate degree in psychology at the University of North Carolina at Asheville and her doctoral degree in clinical psychology at Pacific University in Oregon. Alyssa's therapeutic style is an eclectic mix of evidence-based treatment modalities to help clients and families achieve their goals. She wanted to get her doctorate so that she could have the highest skill set possible to bring to her clients. As a clinician, Alyssa is warm, positive, enthusiastic, collaborative, and solution focused.
Alyssa Scott is a Psychologist in Tennessee who has been practicing since 2022. She obtained her undergraduate degree in psychology at the University of North Carolina at Asheville and her doctoral degree in clinical psychology at Pacific University in Oregon. Alyssa's therapeutic style is an eclectic mix of evidence-based treatment modalities to help clients and families achieve their goals. She wanted to get her doctorate so that she could have the highest skill set possible to bring to her clients. As a clinician, Alyssa is warm, positive, enthusiastic, collaborative, and solution focused.
(423) 592-5311 View (423) 592-5311
Photo of Emily Hand, Licensed Professional Counselor in Johnson City, TN
Emily Hand
Licensed Professional Counselor, LPC, MHSP
Verified Verified
2 Endorsed
Johnson City, TN 37601
Existing can be tough, especially if you're part of a marginalized community, going through a difficult time, or have faced adversity and/or trauma. Our brains want to experience fulfillment and peace, but at times the familiar patterns or approaches we've tried aren't getting us the life we desire. Often we believe there's something wrong with us, when in reality it's what happened to us and the ripple effects of that which are causing us pain and suffering.
Existing can be tough, especially if you're part of a marginalized community, going through a difficult time, or have faced adversity and/or trauma. Our brains want to experience fulfillment and peace, but at times the familiar patterns or approaches we've tried aren't getting us the life we desire. Often we believe there's something wrong with us, when in reality it's what happened to us and the ripple effects of that which are causing us pain and suffering.
(423) 445-0251 View (423) 445-0251
Photo of Kelsey Maloney-Steiner, Licensed Professional Counselor in Johnson City, TN
Kelsey Maloney-Steiner
Licensed Professional Counselor, MSc, LPC, MHSP
Verified Verified
Johnson City, TN 37601  (Online Only)
Kelsey works with individuals, adolescents, and adults. She believes that we live in stories. It is through relationships, conversations, and stories that we create meaning in life. By examining the stories we tell ourselves, re-authoring them, and externalizing problems, then we can construct new and liberating stories. In counseling, Kelsey uses narrative therapy to engage with clients in the stories of their lives. She focuses on building an atmosphere of curiosity, respect, and transparency. She believes individuals matter, bearing witness to stories matters, and that individuals have strengths and the power to change.
Kelsey works with individuals, adolescents, and adults. She believes that we live in stories. It is through relationships, conversations, and stories that we create meaning in life. By examining the stories we tell ourselves, re-authoring them, and externalizing problems, then we can construct new and liberating stories. In counseling, Kelsey uses narrative therapy to engage with clients in the stories of their lives. She focuses on building an atmosphere of curiosity, respect, and transparency. She believes individuals matter, bearing witness to stories matters, and that individuals have strengths and the power to change.
(423) 345-8572 View (423) 345-8572
Photo of CSN Counseling and Consultation, LLC, Licensed Professional Counselor in Johnson City, TN
CSN Counseling and Consultation, LLC
Licensed Professional Counselor, MA, LPCMHSP, S, LMHC, MPA
Verified Verified
1 Endorsed
Johnson City, TN 37604
At CSN Counseling, Your better tomorrows can start today. If you are struggling with feeling "sucked into the stuckness", overwhelmed with the stress of balancing family and work, needing support while confirming your gender identity and sexuality, intimacy and sexual difficulties, or attempting to work through the lingering effects of previous trauma and/or abuse, then I would be honored to sit with you and listen to your story. We can work together to help you gain perspective and insight, while helping you to move through traumas, transitions, and stressors into a healthier and more productive life.
At CSN Counseling, Your better tomorrows can start today. If you are struggling with feeling "sucked into the stuckness", overwhelmed with the stress of balancing family and work, needing support while confirming your gender identity and sexuality, intimacy and sexual difficulties, or attempting to work through the lingering effects of previous trauma and/or abuse, then I would be honored to sit with you and listen to your story. We can work together to help you gain perspective and insight, while helping you to move through traumas, transitions, and stressors into a healthier and more productive life.
(423) 205-5766 View (423) 205-5766
Photo of Inspired Hope Counseling, Clinical Social Work/Therapist in Johnson City, TN
Inspired Hope Counseling
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Johnson City, TN 37601
Are you experiencing memories of traumatic events that are impacting your life in a negative manner? Does it feel like the pain and self blame you are feeling will never go away? Are you struggling with feelings of hopelessness, grieving over the loss of a loved one, or experiencing difficulties in your relationships? Have you tried to solve the problems in your life on your own and realized you need help from someone else? If you answered yes to any of these questions, then you have made the right choice by being here.
Are you experiencing memories of traumatic events that are impacting your life in a negative manner? Does it feel like the pain and self blame you are feeling will never go away? Are you struggling with feelings of hopelessness, grieving over the loss of a loved one, or experiencing difficulties in your relationships? Have you tried to solve the problems in your life on your own and realized you need help from someone else? If you answered yes to any of these questions, then you have made the right choice by being here.
(423) 482-8933 View (423) 482-8933
Photo of Kevin Newhall, Clinical Social Work/Therapist in Johnson City, TN
Kevin Newhall
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Johnson City, TN 37604  (Online Only)
Not accepting new clients
I'm a Licensed Clinical Social Worker offering individual therapy for adults. I have experience in treating mood disorders, anxiety, depression, substance abuse, grief and loss, and relationship issues. I tailor my approach according to the needs and strengths of the client, combining psychodynamic and cognitive behavioral theories. I provide an attentive, honest, and non-judgmental therapeutic environment where clients can increase insight and explore desired change.
I'm a Licensed Clinical Social Worker offering individual therapy for adults. I have experience in treating mood disorders, anxiety, depression, substance abuse, grief and loss, and relationship issues. I tailor my approach according to the needs and strengths of the client, combining psychodynamic and cognitive behavioral theories. I provide an attentive, honest, and non-judgmental therapeutic environment where clients can increase insight and explore desired change.
(423) 264-2469 View (423) 264-2469
Photo of Stacey Shine, Licensed Professional Counselor in Johnson City, TN
Stacey Shine
Licensed Professional Counselor, LPC
Verified Verified
Johnson City, TN 37615  (Online Only)
I enjoying working with clients who are ready to get back to their optimal level of functioning. We all get in ruts and go through hard times. My goal is to help my clients figure out how to gain skills to get past what they are going through currently and be able to tackle any issues in the future as well.
I enjoying working with clients who are ready to get back to their optimal level of functioning. We all get in ruts and go through hard times. My goal is to help my clients figure out how to gain skills to get past what they are going through currently and be able to tackle any issues in the future as well.
(423) 205-7099 View (423) 205-7099

See more therapy options for Johnson City

How does your Therapist compare?

Number of Therapists in Johnson City, TN

100+

Average cost per session

$100

Therapists in Johnson City, TN who prioritize treating:

91% Anxiety
84% Depression
73% Relationship Issues
72% Trauma and PTSD
67% Self Esteem
65% Coping Skills
64% Stress

Average years in practice

10 Years

Top 3 insurances accepted

87% Cigna and Evernorth
76% Aetna
73% UnitedHealthcare UHC | UBH

How Therapists in Johnson City, TN see their clients

80% In Person and Online
20% Online Only

Gender breakdown

74% Female
25% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Johnson City?

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.