Therapists in Northwest, Chula Vista, CA

Photo of Nancy Cowden, Marriage & Family Therapist, LMFT
Nancy Cowden
Marriage & Family Therapist, LMFT
Online Only
Are you and your partner caught in a cycle of arguments that leave you feeling frustrated and disconnected? Small disagreements spiral into big fights, making it hard to feel heard or understood. Even during calm moments, the connection you once shared feels distant. You both want to restore the intimacy, trust, and friendship that brought you together, but breaking the negative patterns on your own feels overwhelming. If you’re ready for change but feel unsure about where to start you're in the right place. I help couples rediscover their connection and rebuild their relationships with compassion and practical tools.
Are you and your partner caught in a cycle of arguments that leave you feeling frustrated and disconnected? Small disagreements spiral into big fights, making it hard to feel heard or understood. Even during calm moments, the connection you once shared feels distant. You both want to restore the intimacy, trust, and friendship that brought you together, but breaking the negative patterns on your own feels overwhelming. If you’re ready for change but feel unsure about where to start you're in the right place. I help couples rediscover their connection and rebuild their relationships with compassion and practical tools.
(619) 870-1931 View (619) 870-1931
Photo of Samantha Rojanasupya, Clinical Social Work/Therapist, LCSW
Samantha Rojanasupya
Clinical Social Work/Therapist, LCSW
Online Only
Hi there! My name is Samantha Rojanasupya (Sam) and I am a Licensed Clinical Social Worker (LCSW). I am a compassionate therapist who is committed to providing a safe space for clients while navigating through life transitions, anxiety, perfectionism, self-esteem, family dynamics, and ready to strengthen meaningful relationships. I would be honored to join alongside your journey toward overcoming life challenges and creating positive change. I enjoy working with teens (16+) and young adults.
Hi there! My name is Samantha Rojanasupya (Sam) and I am a Licensed Clinical Social Worker (LCSW). I am a compassionate therapist who is committed to providing a safe space for clients while navigating through life transitions, anxiety, perfectionism, self-esteem, family dynamics, and ready to strengthen meaningful relationships. I would be honored to join alongside your journey toward overcoming life challenges and creating positive change. I enjoy working with teens (16+) and young adults.
(619) 597-2120 View (619) 597-2120
Photo of Lizeth V Ma, Marriage & Family Therapist, LMFT, MA
Lizeth V Ma
Marriage & Family Therapist, LMFT, MA
Northwest, Chula Vista, CA 91910
I am a passionate clinical therapist who loves working with children, women, couples and families going through challenging times. Are you and your your child having trouble communicating? Are you and your spouse having trouble communicating? Do you see them going through a hard time, long to help but don't know how? Do you suffer from Bipolar Disorder? I am here for you. Do you feel undone by anxiety or depression and don't know how to "shake it off"? Please call today, My number one goal is to help in the most comfortable and holistic approach possible. It's OK, not to be OK. Together we can get there, one step at a time.
I am a passionate clinical therapist who loves working with children, women, couples and families going through challenging times. Are you and your your child having trouble communicating? Are you and your spouse having trouble communicating? Do you see them going through a hard time, long to help but don't know how? Do you suffer from Bipolar Disorder? I am here for you. Do you feel undone by anxiety or depression and don't know how to "shake it off"? Please call today, My number one goal is to help in the most comfortable and holistic approach possible. It's OK, not to be OK. Together we can get there, one step at a time.
(858) 433-4356 View (858) 433-4356
Photo of Gina Reynoso, Marriage & Family Therapist, LMFT
Gina Reynoso
Marriage & Family Therapist, LMFT
Northwest, Chula Vista, CA 91910
I have extensive experience working with trauma through domestic violence survivors. In addition to specializing in all relationship issues, anxiety, depression, and couple's therapy, I have taught parenting classes and facilitated domestic violence groups for children and women survivors of domestic violence. I also facilitated groups on healthy relationships and women's empowerment groups.
I have extensive experience working with trauma through domestic violence survivors. In addition to specializing in all relationship issues, anxiety, depression, and couple's therapy, I have taught parenting classes and facilitated domestic violence groups for children and women survivors of domestic violence. I also facilitated groups on healthy relationships and women's empowerment groups.
(310) 956-4360 View (310) 956-4360
Photo of Fabian Escobedo (In Person Sessions Available), Clinical Social Work/Therapist, LCSW, EMDR
Fabian Escobedo (In Person Sessions Available)
Clinical Social Work/Therapist, LCSW, EMDR
8 Endorsed
Northwest, Chula Vista, CA 91910
I specialize in helping teens and adults with getting unstuck from the effects of trauma. If you’re feeling more angry/irritated than usual, it’s hard trusting others, having difficult memories or dreams, feeling anxious, sad or lonely even if you’re surrounded by people, and you're struggling with your relationship(s), you may be experiencing side effects of trauma. You’ve been postponing professional help, hoping this would go away by itself but you are realizing that now may be the time? I get it. I can help heal those internal wounds so you can enjoy your best version of yourself.
I specialize in helping teens and adults with getting unstuck from the effects of trauma. If you’re feeling more angry/irritated than usual, it’s hard trusting others, having difficult memories or dreams, feeling anxious, sad or lonely even if you’re surrounded by people, and you're struggling with your relationship(s), you may be experiencing side effects of trauma. You’ve been postponing professional help, hoping this would go away by itself but you are realizing that now may be the time? I get it. I can help heal those internal wounds so you can enjoy your best version of yourself.
(619) 383-2442 View (619) 383-2442
Photo of Linda Anne Proctor, Clinical Social Work/Therapist, LCSW
Linda Anne Proctor
Clinical Social Work/Therapist, LCSW
Northwest, Chula Vista, CA 91910
I bring 40 years of clinical experience with diverse populations. Advanced training in Couples Therapy, Grief Recovery, trauma treatment and mind-body modalities. Clients describe me as having strong intuition/attunement. My gentle, but direct approach has helped them with self-compassion and more effective coping strategies. Couples have said ʻyou are not only taking in our words, but also understand and translate for us both in a language so we can understand each other.ʻ Additionally, ʻyou help us see whatʻs driving our reaction, opening up creativity and empathy; fostering a deeper connection.ʻ
I bring 40 years of clinical experience with diverse populations. Advanced training in Couples Therapy, Grief Recovery, trauma treatment and mind-body modalities. Clients describe me as having strong intuition/attunement. My gentle, but direct approach has helped them with self-compassion and more effective coping strategies. Couples have said ʻyou are not only taking in our words, but also understand and translate for us both in a language so we can understand each other.ʻ Additionally, ʻyou help us see whatʻs driving our reaction, opening up creativity and empathy; fostering a deeper connection.ʻ
(619) 775-1473 View (619) 775-1473
Photo of Patricia G Navarro, Marriage & Family Therapist, MA, MFT
Patricia G Navarro
Marriage & Family Therapist, MA, MFT
1 Endorsed
Northwest, Chula Vista, CA 91910
Hi, I’m Patricia Navarro, a bilingual (Spanish/English) therapist with over 40 years of experience helping individuals, couples, families, and children. I specialize in supporting people through challenges like anxiety, depression, grief, relationship issues, and work stress. I’m certified in grief counseling, trained in mindfulness, and use different approaches to meet your unique needs. My style is warm, collaborative, and focused on helping you feel heard, supported, and empowered.
Hi, I’m Patricia Navarro, a bilingual (Spanish/English) therapist with over 40 years of experience helping individuals, couples, families, and children. I specialize in supporting people through challenges like anxiety, depression, grief, relationship issues, and work stress. I’m certified in grief counseling, trained in mindfulness, and use different approaches to meet your unique needs. My style is warm, collaborative, and focused on helping you feel heard, supported, and empowered.
(619) 658-3540 View (619) 658-3540
Photo of Maria Guadalupe Anguiano, Marriage & Family Therapist, LMFT
Maria Guadalupe Anguiano
Marriage & Family Therapist, LMFT
1 Endorsed
Northwest, Chula Vista, CA 91910
Waitlist for new clients
You’re the strong one. The go-to person. The helper. And lately… you’re tired—physically, emotionally, mentally, spiritually. You’ve read the books, maybe even tried therapy, but you're craving something deeper. A space that's real, culturally aware, and focused on healing the root, not just the symptoms. I’m Maria Anguiano and I work with trauma from a holistic perspective, helping individuals navigate burnout, anxiety, relationship patterns, and life transitions. I want to help you break free from burnout and find lasting balance, healing, and clarity in your life.
You’re the strong one. The go-to person. The helper. And lately… you’re tired—physically, emotionally, mentally, spiritually. You’ve read the books, maybe even tried therapy, but you're craving something deeper. A space that's real, culturally aware, and focused on healing the root, not just the symptoms. I’m Maria Anguiano and I work with trauma from a holistic perspective, helping individuals navigate burnout, anxiety, relationship patterns, and life transitions. I want to help you break free from burnout and find lasting balance, healing, and clarity in your life.
(619) 975-2918 View (619) 975-2918
Photo of Andrea Calvo, Clinical Social Work/Therapist, LCSW
Andrea Calvo
Clinical Social Work/Therapist, LCSW
Online Only
My name is Andrea Calvo and I am a Licensed Clinical Social Worker (License no. 108211). My focus balances an exploration of past strengths and present goals. I can help with aging, chronic illness, coping skills, grief, stress, anxiety, depression, and more. I work with an adult population. I do have specialty in working with an older adult population. My theoretical approach when working with clients involves a cognitive behavioral approach, as well as solution focused therapy. I believe that change happens through empowerment.
My name is Andrea Calvo and I am a Licensed Clinical Social Worker (License no. 108211). My focus balances an exploration of past strengths and present goals. I can help with aging, chronic illness, coping skills, grief, stress, anxiety, depression, and more. I work with an adult population. I do have specialty in working with an older adult population. My theoretical approach when working with clients involves a cognitive behavioral approach, as well as solution focused therapy. I believe that change happens through empowerment.
(619) 658-4473 View (619) 658-4473
Photo of Naomi Jimenez, Marriage & Family Therapist, LMFT
Naomi Jimenez
Marriage & Family Therapist, LMFT
Online Only
Hello, I'm Naomi Jimenez and I am a Licensed Marriage and Family Therapist (LMFT) based in California and working with clients statewide using a telehealth platform. I work with adolescents, preteens, and teenagers from a variety of backgrounds who struggle with anxiety, grief, and trauma.
Hello, I'm Naomi Jimenez and I am a Licensed Marriage and Family Therapist (LMFT) based in California and working with clients statewide using a telehealth platform. I work with adolescents, preteens, and teenagers from a variety of backgrounds who struggle with anxiety, grief, and trauma.
(619) 626-2177 View (619) 626-2177
Photo of Leslie Farias Sanchez, Marriage & Family Therapist, LMFT
Leslie Farias Sanchez
Marriage & Family Therapist, LMFT
15 Endorsed
Northwest, Chula Vista, CA 91910
Not accepting new clients
Do you feel like your childhood experiences are impacting your present? Were you raised by parents who were emotionally unavailable, absent, or immature? Are you struggling with feelings of abandonment, low self-worth, or setting healthy boundaries? Do you find it hard to break free from old patterns and make positive changes in your life? If these questions resonate with you, you are not alone. Many adult children of emotionally immature or absent parents face these challenges. The emotional wounds from your past can impact how you see yourself, how you relate to others, and how you manage your own needs and boundaries.
Do you feel like your childhood experiences are impacting your present? Were you raised by parents who were emotionally unavailable, absent, or immature? Are you struggling with feelings of abandonment, low self-worth, or setting healthy boundaries? Do you find it hard to break free from old patterns and make positive changes in your life? If these questions resonate with you, you are not alone. Many adult children of emotionally immature or absent parents face these challenges. The emotional wounds from your past can impact how you see yourself, how you relate to others, and how you manage your own needs and boundaries.
(619) 373-9351 View (619) 373-9351
Photo of Daniel Moody, Marriage & Family Therapist, LMFT
Daniel Moody
Marriage & Family Therapist, LMFT
Online Only
Daniel Moody, MS, LMFT. I prefer to meet clients where they are at, assist them in defining their treatment goals, and provide them with objective and evidence-based strategies. I hold all clients in unconditional positive regard and believe that given the right conditions, everyone is capable of self-directed growth. I specialize in attachment theory and have an integrated approach that utilizes the interpersonal process in therapy to provide corrective emotional experiences.
Daniel Moody, MS, LMFT. I prefer to meet clients where they are at, assist them in defining their treatment goals, and provide them with objective and evidence-based strategies. I hold all clients in unconditional positive regard and believe that given the right conditions, everyone is capable of self-directed growth. I specialize in attachment theory and have an integrated approach that utilizes the interpersonal process in therapy to provide corrective emotional experiences.
(858) 923-5686 View (858) 923-5686
Photo of Cristina Zamora, Marriage & Family Therapist
Cristina Zamora
Marriage & Family Therapist
Northwest, Chula Vista, CA 91910
Not accepting new clients
My works is for people to be embraced and receive the guidance of truth. Over the 20 years of my work I witness the power of Truth in it's transformative nature. Being embraced by a healing relationship requires vulnerability and truth baring requires courage, and courage requires hope. I want to invite you to take the wildest journey you can imagine. A journey into yourself with open arms to embrace who you were meant to be.
My works is for people to be embraced and receive the guidance of truth. Over the 20 years of my work I witness the power of Truth in it's transformative nature. Being embraced by a healing relationship requires vulnerability and truth baring requires courage, and courage requires hope. I want to invite you to take the wildest journey you can imagine. A journey into yourself with open arms to embrace who you were meant to be.
(619) 404-5837 View (619) 404-5837
Photo of Patricia Shealy, Marriage & Family Therapist, LMFT
Patricia Shealy
Marriage & Family Therapist, LMFT
Online Only
I am a Psychodynamic Psychotherapist. I like Depth Psychology and believe that our early lives are linked to issues in our adult lives. Making connections and unraveling your story is growth forward. I use Cognitive Behavioral Therapy (CBT) and trained in Brain spotting as a trauma technique. Trauma and substance abuse treatment.
I am a Psychodynamic Psychotherapist. I like Depth Psychology and believe that our early lives are linked to issues in our adult lives. Making connections and unraveling your story is growth forward. I use Cognitive Behavioral Therapy (CBT) and trained in Brain spotting as a trauma technique. Trauma and substance abuse treatment.
(858) 758-7435 View (858) 758-7435
Photo of Joanna Garay, Licensed Professional Clinical Counselor, LPCC
Joanna Garay
Licensed Professional Clinical Counselor, LPCC
Northwest, Chula Vista, CA 91910
If you’re feeling alone, misunderstood, or like a burden to those around you I am here to hold space for you. Sometimes life can feel dark, stagnant or not what we expected it to be and a simple, "it gets better, hang in there" isn't helpful. I can help you process any emotions, gain a different perspective and develop tools in order to help life feel meaningful again. Healing takes time, space and help from those around us. Anyone looking for help with attachment issues, life transitions, trauma, racial stress, addiction, anxiety and depression. I am here to help. (Spanish speaking as well)
If you’re feeling alone, misunderstood, or like a burden to those around you I am here to hold space for you. Sometimes life can feel dark, stagnant or not what we expected it to be and a simple, "it gets better, hang in there" isn't helpful. I can help you process any emotions, gain a different perspective and develop tools in order to help life feel meaningful again. Healing takes time, space and help from those around us. Anyone looking for help with attachment issues, life transitions, trauma, racial stress, addiction, anxiety and depression. I am here to help. (Spanish speaking as well)
(619) 320-2525 View (619) 320-2525
Photo of Priscilla Palicki McCullough, Clinical Social Work/Therapist, LCSW
Priscilla Palicki McCullough
Clinical Social Work/Therapist, LCSW
Northwest, Chula Vista, CA 91910
My mindset is to always meet you where you are at on the day you come to visit. Therapy looks different for everyone, its not as easy as a "one-stop shop." However, here are some things you can expect: We will begin with an intake and I will learn a little more about you, what you are open to sharing and how we can work together to meet your goal. Progress can look like many things, one aspect to look at is how you are doing emotionally in relation to the goal you've set. I enjoy working with people who allow themselves to be open to the process of healing and change as we work through it together.
My mindset is to always meet you where you are at on the day you come to visit. Therapy looks different for everyone, its not as easy as a "one-stop shop." However, here are some things you can expect: We will begin with an intake and I will learn a little more about you, what you are open to sharing and how we can work together to meet your goal. Progress can look like many things, one aspect to look at is how you are doing emotionally in relation to the goal you've set. I enjoy working with people who allow themselves to be open to the process of healing and change as we work through it together.
(858) 544-6163 View (858) 544-6163
Photo of Theresa Mary Comito, Marriage & Family Therapist, LMFT
Theresa Mary Comito
Marriage & Family Therapist, LMFT
Northwest, Chula Vista, CA 91910
I will provide a supportive, empathic and non-judgmental space for you to explore problematic relationship styles, trauma, abuse, and loss in order to heal the past and promote a feeling of greater personal freedom. My therapeutic approach emphasizes "here and now" relationships, embracing your strengths and getting in touch with mind, body and spirit.
I will provide a supportive, empathic and non-judgmental space for you to explore problematic relationship styles, trauma, abuse, and loss in order to heal the past and promote a feeling of greater personal freedom. My therapeutic approach emphasizes "here and now" relationships, embracing your strengths and getting in touch with mind, body and spirit.
(619) 346-7481 View (619) 346-7481
Photo of Dat Dinh, Marriage & Family Therapist, LMFT
Dat Dinh
Marriage & Family Therapist, LMFT
Online Only
All of us need mental health support in varying ways-in order to better ourselves, better our lives. It can range from a word of encouragement to needing special mental health services. Wherever you are in your journey, I applaud you for taking the courage to reach out for mental health services. For more than 13 years, I have been providing mental health services to people with severe and persistent mental health needs, such as severe depression, anxiety, panic attacks, schizophrenia, schizoaffective, and substance addictions. I feel blessed that they gave me the opportunity to walk with them when they feel vulnerable
All of us need mental health support in varying ways-in order to better ourselves, better our lives. It can range from a word of encouragement to needing special mental health services. Wherever you are in your journey, I applaud you for taking the courage to reach out for mental health services. For more than 13 years, I have been providing mental health services to people with severe and persistent mental health needs, such as severe depression, anxiety, panic attacks, schizophrenia, schizoaffective, and substance addictions. I feel blessed that they gave me the opportunity to walk with them when they feel vulnerable
(619) 202-8934 View (619) 202-8934
Photo of Esperanza Sanchez, Clinical Social Work/Therapist, MSW, LCSW
Esperanza Sanchez
Clinical Social Work/Therapist, MSW, LCSW
3 Endorsed
Northwest, Chula Vista, CA 91910
My name is Esperanza Sanchez. I am the daughter of Mexican immigrants. I am an Adult Child of an Alcoholic (dad). My mom lost herself in caretaking her husband and 8 children. This family chaos and emotional emptiness led me to help others like myself. When we grow up without safety, protection, boundaries, guidance we have to figure It out on our own. What the hell do we know?! But we sort of figure it out; graduating from school, college, become professionally successful but we can't shake IT off. . . heart racing, mind racing, the negative voice: "que pendeja eres" (you're so stupid), "tu no puedes. . . (you can't do. . .)
My name is Esperanza Sanchez. I am the daughter of Mexican immigrants. I am an Adult Child of an Alcoholic (dad). My mom lost herself in caretaking her husband and 8 children. This family chaos and emotional emptiness led me to help others like myself. When we grow up without safety, protection, boundaries, guidance we have to figure It out on our own. What the hell do we know?! But we sort of figure it out; graduating from school, college, become professionally successful but we can't shake IT off. . . heart racing, mind racing, the negative voice: "que pendeja eres" (you're so stupid), "tu no puedes. . . (you can't do. . .)
(619) 568-5621 View (619) 568-5621
Photo of Hugo Sibrian, Marriage & Family Therapist
Hugo Sibrian
Marriage & Family Therapist
Online Only
As a therapist, Hugo works with his clients to identify their desires and empower them to make changes in their lives. He understands that making the decision to seek help can be difficult, and he uses an approach that is compassionate, direct, and non-judgmental to create an environment where his clients feel supported in their counseling journey.
As a therapist, Hugo works with his clients to identify their desires and empower them to make changes in their lives. He understands that making the decision to seek help can be difficult, and he uses an approach that is compassionate, direct, and non-judgmental to create an environment where his clients feel supported in their counseling journey.
(619) 776-3857 View (619) 776-3857

See more therapy options for Northwest, Chula Vista

How does your Therapist compare?

Number of Therapists in Northwest, Chula Vista, CA

100+

Average cost per session

$150

Therapists in Northwest, Chula Vista, CA who prioritize treating:

92% Anxiety
88% Depression
75% Trauma and PTSD
66% Relationship Issues
65% Self Esteem
64% Coping Skills
59% Life Transitions

Average years in practice

15 Years

Top 3 insurances accepted

87% Aetna
77% Cigna and Evernorth
73% Optum

How Therapists in Northwest, Chula Vista, CA see their clients

65% In Person and Online
35% Online Only

Gender breakdown

77% Female
23% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Northwest, Chula Vista?

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.