Therapists in Sierra Madre, CA

Photo of Sulfiati Meariam Magnuson - Sulfiati's Threshold Counseling, Counselor, MA, LMHC
Sulfiati's Threshold Counseling
Counselor, MA, LMHC
Online Only
Are you at a crossroads? Throughout life, we experience "little deaths" that change our life’s course. Loss of a dream, health, family, the earth we stand on, job, marriage, relationship, country or beliefs can suddenly take us over a threshold, chosen or not into a new world where life no longer makes any sense. Our old tools and ways of coping or understanding our self or our world are no longer enough to pilot us to the other side of what can feel like a vast, deep and turbulent river. While often terrifying, these are the golden opportunities in which our true nature, our soul or purpose in life can be revealed.
Are you at a crossroads? Throughout life, we experience "little deaths" that change our life’s course. Loss of a dream, health, family, the earth we stand on, job, marriage, relationship, country or beliefs can suddenly take us over a threshold, chosen or not into a new world where life no longer makes any sense. Our old tools and ways of coping or understanding our self or our world are no longer enough to pilot us to the other side of what can feel like a vast, deep and turbulent river. While often terrifying, these are the golden opportunities in which our true nature, our soul or purpose in life can be revealed.
(626) 727-8053 View (626) 727-8053
Photo of Charles Jones, Marriage & Family Therapist, LMFT
Charles Jones
Marriage & Family Therapist, LMFT
Online Only
My name is Charles Jones. I go by Cass. For thirty years I have worked as an Addictions and Marriage & Family Therapist. I began my career working in recovery programs with addicts, alcoholics, and their families. As a Program Director with Los Angeles County, I worked with foster children and at-risk youth. I led the Hospital Diversion, Emergency Response, and Wraparound teams. The majority of my career has been in private practice in the Pasadena-Sierra Madre, CA areas. I find great satisfaction teaching children and adolescents to heal trauma and gain coping techniques and skills that can help them to become successful adults.
My name is Charles Jones. I go by Cass. For thirty years I have worked as an Addictions and Marriage & Family Therapist. I began my career working in recovery programs with addicts, alcoholics, and their families. As a Program Director with Los Angeles County, I worked with foster children and at-risk youth. I led the Hospital Diversion, Emergency Response, and Wraparound teams. The majority of my career has been in private practice in the Pasadena-Sierra Madre, CA areas. I find great satisfaction teaching children and adolescents to heal trauma and gain coping techniques and skills that can help them to become successful adults.
(831) 208-3386 View (831) 208-3386
Photo of Catherine Pileggi, Marriage & Family Therapist, LMFT
Catherine Pileggi
Marriage & Family Therapist, LMFT
6 Endorsed
Sierra Madre, CA 91024
Hi! I’m Cate. I help women in their 20s to 50s to heal and change from past traumas and hurts by understanding and addressing the root cause of struggles. Things we learn in our past can stick with us and cause pain, holding us back from living full and happy lives. I’m here to help you work through feelings of overwhelm, anxiety, loneliness, and disconnection to feel more like your authentic self. Specialties include: Trauma, EMDR, narcissistic abuse, religious trauma, relationship issues, painful childhoods, insecure attachment, perfectionism, people pleasing
Hi! I’m Cate. I help women in their 20s to 50s to heal and change from past traumas and hurts by understanding and addressing the root cause of struggles. Things we learn in our past can stick with us and cause pain, holding us back from living full and happy lives. I’m here to help you work through feelings of overwhelm, anxiety, loneliness, and disconnection to feel more like your authentic self. Specialties include: Trauma, EMDR, narcissistic abuse, religious trauma, relationship issues, painful childhoods, insecure attachment, perfectionism, people pleasing
(626) 669-4024 View (626) 669-4024
Photo of Dr. Carrie N Dilley, Psychologist, PhD
Dr. Carrie N Dilley
Psychologist, PhD
2 Endorsed
Sierra Madre, CA 91024
I emphasize the importance of every individual knowing that they have been understood. I am passionate about helping others know themselves better and I meet my clients wherever they are regardless of age, area of struggle, or disability. My specialization is supporting neurodivergent individuals with Autism Spectrum Disorders, Attention Issues, Behavioral Challenges, Impulse Control Issues, Learning Disabilities, and Regulation and Sensory Processing Disorders. I provide individual, family and group therapy, parent coaching, neuropsychological assessment, and school consultations.
I emphasize the importance of every individual knowing that they have been understood. I am passionate about helping others know themselves better and I meet my clients wherever they are regardless of age, area of struggle, or disability. My specialization is supporting neurodivergent individuals with Autism Spectrum Disorders, Attention Issues, Behavioral Challenges, Impulse Control Issues, Learning Disabilities, and Regulation and Sensory Processing Disorders. I provide individual, family and group therapy, parent coaching, neuropsychological assessment, and school consultations.
(626) 654-2396 View (626) 654-2396
Photo of Chellina Okumura, Marriage & Family Therapist, LMFT
Chellina Okumura
Marriage & Family Therapist, LMFT
Sierra Madre, CA 91024
Therapy is a process that involves teamwork, so I’d love the opportunity to work together with you to explore how we can build upon your existing strengths and resources toward personal growth, well-being, and happiness (whatever that looks like for you)!
Therapy is a process that involves teamwork, so I’d love the opportunity to work together with you to explore how we can build upon your existing strengths and resources toward personal growth, well-being, and happiness (whatever that looks like for you)!
(626) 349-6739 View (626) 349-6739
Photo of Cynthia Cooper, Marriage & Family Therapist, LMFT
Cynthia Cooper
Marriage & Family Therapist, LMFT
Sierra Madre, CA 91024
Not accepting new clients
Perhaps you are experiencing anxiety, depression or having relationship or work difficulties. Are you wanting to move forward in your life after a crisis, health challenge or loss of a loved one? Are you needing some tools or techniques which will help improve your self-confidence, self-care or communication with others?
Perhaps you are experiencing anxiety, depression or having relationship or work difficulties. Are you wanting to move forward in your life after a crisis, health challenge or loss of a loved one? Are you needing some tools or techniques which will help improve your self-confidence, self-care or communication with others?
(626) 702-3543 View (626) 702-3543
Photo of Mick Silvers, Marriage & Family Therapist Associate, MA, AMFT
Mick Silvers
Marriage & Family Therapist Associate, MA, AMFT
8 Endorsed
Sierra Madre, CA 91024
This is therapy for men tired of pretending they're fine! You’ve done everything asked of you—worked hard, kept your emotions in check, and played the part expected of you. Yet inside, you feel anxious, disconnected, and quietly wonder: Is this really all there is? For many men, the pain isn’t loud—it’s buried beneath frustration, worry, numbness, or shame. You might overthink every little detail, constantly fear what others think, or feel nothing at all, just drifting through life. The drive that once pushed you forward now simply wears you down. You’re tired of hustling for a version of manhood that no longer feels like you.
This is therapy for men tired of pretending they're fine! You’ve done everything asked of you—worked hard, kept your emotions in check, and played the part expected of you. Yet inside, you feel anxious, disconnected, and quietly wonder: Is this really all there is? For many men, the pain isn’t loud—it’s buried beneath frustration, worry, numbness, or shame. You might overthink every little detail, constantly fear what others think, or feel nothing at all, just drifting through life. The drive that once pushed you forward now simply wears you down. You’re tired of hustling for a version of manhood that no longer feels like you.
(626) 986-7991 View (626) 986-7991
Photo of Heather Inouye, Marriage & Family Therapist, MS, MA, LMFT
Heather Inouye
Marriage & Family Therapist, MS, MA, LMFT
Sierra Madre, CA 91024
I help people with diverse cultural backgrounds to solidify healthy personal identities, locate themselves within larger communal identities, identify their values, needs, and preferences, and to communicate these in healthy and culturally sensitive ways so that they can live personally meaningful and satisfying lives, while still honoring their parents, families, and cultures. I also help clients with other concerns, including stress, anxiety, depression, career concerns, work-life balance, life transitions, cross-cultural adaptation, and intercultural relationships.
I help people with diverse cultural backgrounds to solidify healthy personal identities, locate themselves within larger communal identities, identify their values, needs, and preferences, and to communicate these in healthy and culturally sensitive ways so that they can live personally meaningful and satisfying lives, while still honoring their parents, families, and cultures. I also help clients with other concerns, including stress, anxiety, depression, career concerns, work-life balance, life transitions, cross-cultural adaptation, and intercultural relationships.
(626) 593-6103 View (626) 593-6103
Kathleen Magnani
Psychologist, PhD
Sierra Madre, CA 91024
I am a licensed psychologist who works with adults who face either temporary distress in their lives or longstanding problems with depression, anxiety, trauma, or personal/communication difficulties. I also specialize in the treatment of the psychological problems and decisions encountered in infertility and have expertise in helping persons, within their religious framework, resolve negative or traumatic experiences.
I am a licensed psychologist who works with adults who face either temporary distress in their lives or longstanding problems with depression, anxiety, trauma, or personal/communication difficulties. I also specialize in the treatment of the psychological problems and decisions encountered in infertility and have expertise in helping persons, within their religious framework, resolve negative or traumatic experiences.
(626) 768-9912 View (626) 768-9912
Photo of Brianna Winbigler, Marriage & Family Therapist, MA, LMFT, APCC
Brianna Winbigler
Marriage & Family Therapist, MA, LMFT, APCC
2 Endorsed
Online Only
I'm so glad you're here. I want to share some hopeful news with you: The way you are feeling right now is temporary. Perhaps you’ve been feeling stuck, stressed, unable to cope with life’s challenges, operating on auto-pilot, missing your sense of purpose, or struggling in your relationships. In these seasons, it can seem like life is just passing you by, while you miss out on moments of joy and connection. Just being here on your search for a therapist is a sign that you’re ready for a healthy and refreshing change in your life. Your desire to feel better is proof that it is possible.
I'm so glad you're here. I want to share some hopeful news with you: The way you are feeling right now is temporary. Perhaps you’ve been feeling stuck, stressed, unable to cope with life’s challenges, operating on auto-pilot, missing your sense of purpose, or struggling in your relationships. In these seasons, it can seem like life is just passing you by, while you miss out on moments of joy and connection. Just being here on your search for a therapist is a sign that you’re ready for a healthy and refreshing change in your life. Your desire to feel better is proof that it is possible.
(323) 861-3173 View (323) 861-3173
Photo of Sharon L Teruya, Psychologist, PhD
Sharon L Teruya
Psychologist, PhD
Online Only
Waitlist for new clients
I am known for working well with individuals who are shy and who may be fearful of entering therapy. I have a specialization in the diagnosis/assessment and treatment of AD/HD and learning disorders such as dyslexia. My therapeutic approach is primarily cognitive behavioral. Pragmatism describes my approach to treatment. Management of chronic mental illness, and adjustment issues relating to ethnic/cultural/generational and religious issues are also areas which I specialize in. I believe that at times addressing questions pertaining to meaning in life can be as important as changing behavioral patterns and emotions.
I am known for working well with individuals who are shy and who may be fearful of entering therapy. I have a specialization in the diagnosis/assessment and treatment of AD/HD and learning disorders such as dyslexia. My therapeutic approach is primarily cognitive behavioral. Pragmatism describes my approach to treatment. Management of chronic mental illness, and adjustment issues relating to ethnic/cultural/generational and religious issues are also areas which I specialize in. I believe that at times addressing questions pertaining to meaning in life can be as important as changing behavioral patterns and emotions.
(626) 344-8993 View (626) 344-8993
Photo of Connie Vaillancourt, Marriage & Family Therapist, LMFT
Connie Vaillancourt
Marriage & Family Therapist, LMFT
Online Only
Versed in multiple evidenced-based treatment approaches, I have over 15 years of experience working with individuals, couples, and groups of various ethnic, religious, and socio-economic backgrounds. I have worked in residential settings, schools, private practice, non-profit organizations and intensive out-patient hospital programs (IOP). As a Marriage and Family Therapist, I have found that the nature of the therapeutic relationship is the underpinning and primary vehicle for effecting positive change.
Versed in multiple evidenced-based treatment approaches, I have over 15 years of experience working with individuals, couples, and groups of various ethnic, religious, and socio-economic backgrounds. I have worked in residential settings, schools, private practice, non-profit organizations and intensive out-patient hospital programs (IOP). As a Marriage and Family Therapist, I have found that the nature of the therapeutic relationship is the underpinning and primary vehicle for effecting positive change.
(626) 466-3526 View (626) 466-3526
Photo of Stephanie Harimoto - Stephanie Harimoto, Trauma Therapist, Marriage & Family Therapist, MA, LMFT, EMDR
Stephanie Harimoto, Trauma Therapist
Marriage & Family Therapist, MA, LMFT, EMDR
26 Endorsed
Sierra Madre, CA 91024
You learned early that keeping the peace, staying agreeable, and hiding parts of yourself helped you stay safe. Now your own needs end up on the back burner while anxiety, guilt, and self-doubt follow you everywhere. You replay conversations, question your instincts, and struggle to trust your inner voice. Maybe you grew up in a high-control environment, experienced religious or spiritual trauma, or learned in your family that parts of you were unsafe to express. Trauma therapy can help you understand these patterns, process shame, reconnect with your body, and rebuild a sense of self-trust.
You learned early that keeping the peace, staying agreeable, and hiding parts of yourself helped you stay safe. Now your own needs end up on the back burner while anxiety, guilt, and self-doubt follow you everywhere. You replay conversations, question your instincts, and struggle to trust your inner voice. Maybe you grew up in a high-control environment, experienced religious or spiritual trauma, or learned in your family that parts of you were unsafe to express. Trauma therapy can help you understand these patterns, process shame, reconnect with your body, and rebuild a sense of self-trust.
(213) 296-0429 View (213) 296-0429
Photo of Regina Schaefer, Marriage & Family Therapist, PhD, EdD, LMFT
Regina Schaefer
Marriage & Family Therapist, PhD, EdD, LMFT
Online Only
Not accepting new clients
When you believe you "cannot get there from here," I believe you usually can. Sometimes the stress of life situations blocks your own native creativity and problem solving abilities. Let me assist you to brainstorm and come up with workable solutions to the situation which has caused you to seek therapy.
When you believe you "cannot get there from here," I believe you usually can. Sometimes the stress of life situations blocks your own native creativity and problem solving abilities. Let me assist you to brainstorm and come up with workable solutions to the situation which has caused you to seek therapy.
(626) 898-5964 View (626) 898-5964
Photo of Dr. Elisa Hernandez, Psychologist, PhD
Dr. Elisa Hernandez
Psychologist, PhD
1 Endorsed
Online Only
Is it hard to be present with engaged with your life? Do you struggle with honoring your own wants and needs? Do you feel pulled in different directions? Every person is the expert on their own life, but there are times when context, perspective, and values get distorted by emotional pain, life circumstances, and societal ills. Would you like to untangle the story of yourself and your life? Do you dream of using your vision and values to create a path towards your optimal self? Working together, we can create an integrated, strengths-based, values-driven narrative that honors your past and paves a path towards your desired future.
Is it hard to be present with engaged with your life? Do you struggle with honoring your own wants and needs? Do you feel pulled in different directions? Every person is the expert on their own life, but there are times when context, perspective, and values get distorted by emotional pain, life circumstances, and societal ills. Would you like to untangle the story of yourself and your life? Do you dream of using your vision and values to create a path towards your optimal self? Working together, we can create an integrated, strengths-based, values-driven narrative that honors your past and paves a path towards your desired future.
(626) 663-2263 View (626) 663-2263
Photo of Keri Mills, Licensed Professional Clinical Counselor, LPC
Keri Mills
Licensed Professional Clinical Counselor, LPC
Online Only
I am a compassionate and dedicated therapist committed to helping individuals navigate life's challenges. With 6 years of experience in cognitive behavioral therapy, mindfulness, trauma recovery & life transitions. My goal is to create a safe, supportive space where you can explore your thoughts, feelings, and experiences without judgment. I believe that every person has the strength within them to heal, grow, and create lasting change. Whether you're facing anxiety, depression, relationship struggles, or simply seeking personal growth, I am here to guide you toward a healthier, more balanced life.
I am a compassionate and dedicated therapist committed to helping individuals navigate life's challenges. With 6 years of experience in cognitive behavioral therapy, mindfulness, trauma recovery & life transitions. My goal is to create a safe, supportive space where you can explore your thoughts, feelings, and experiences without judgment. I believe that every person has the strength within them to heal, grow, and create lasting change. Whether you're facing anxiety, depression, relationship struggles, or simply seeking personal growth, I am here to guide you toward a healthier, more balanced life.
(323) 745-8339 View (323) 745-8339
Photo of Kelly Aguirre, Marriage & Family Therapist, MA, LMFT
Kelly Aguirre
Marriage & Family Therapist, MA, LMFT
1 Endorsed
Sierra Madre, CA 91024
Are you finding the transition into motherhood challenging or overwhelming? Whether it be infertility, miscarriage, peri-natal/postpartum depression and anxiety, or simply the challenges of maintaining a sense of self as you care for your family, the most important thing you can do is seek support through this transitional time of your life. I consider it a privilege to walk alongside my clients through each stage of transition. Whether it be a new job, a child, a relationship, or the loss associated with life transitions, I provide a safe space to explore one's feelings and get unstuck.
Are you finding the transition into motherhood challenging or overwhelming? Whether it be infertility, miscarriage, peri-natal/postpartum depression and anxiety, or simply the challenges of maintaining a sense of self as you care for your family, the most important thing you can do is seek support through this transitional time of your life. I consider it a privilege to walk alongside my clients through each stage of transition. Whether it be a new job, a child, a relationship, or the loss associated with life transitions, I provide a safe space to explore one's feelings and get unstuck.
(626) 275-2872 View (626) 275-2872
Photo of Kiana Jannesari, Psychologist, LCP
Kiana Jannesari
Psychologist, LCP
Online Only
Greetings! I am Dr. Kiana Jannesari. I am a licensed psychologist with expertise in diagnosing and treating developmental disorders, as well as anxiety, depression, bipolar, and trauma-related and stressor-related disorders.
Greetings! I am Dr. Kiana Jannesari. I am a licensed psychologist with expertise in diagnosing and treating developmental disorders, as well as anxiety, depression, bipolar, and trauma-related and stressor-related disorders.
(949) 446-1198 View (949) 446-1198
Photo of Susan Merletti, Counselor, LPCC, ATR
Susan Merletti
Counselor, LPCC, ATR
1 Endorsed
Sierra Madre, CA 91024
Have you ever felt that words were not enough? You've tried talking, but it doesn't seem to work, at least not for very long. You find yourself wondering what you can do to feel better. Coping with stress, living with uncertainty and meeting the challenges of everyday life are often difficult to describe in words alone. Imagine what it would feel like to enjoy the process of self-discovery, personal growth and understanding. Your creative process can become your road to emotional wellbeing - a safe and gratifying way to explore difficult experiences and emotions such as fear, sadness, frustration, and anxiety.
Have you ever felt that words were not enough? You've tried talking, but it doesn't seem to work, at least not for very long. You find yourself wondering what you can do to feel better. Coping with stress, living with uncertainty and meeting the challenges of everyday life are often difficult to describe in words alone. Imagine what it would feel like to enjoy the process of self-discovery, personal growth and understanding. Your creative process can become your road to emotional wellbeing - a safe and gratifying way to explore difficult experiences and emotions such as fear, sadness, frustration, and anxiety.
(626) 658-3105 View (626) 658-3105
Photo of Ruth Fong, Marriage & Family Therapist, LMFT, PMH-C
Ruth Fong
Marriage & Family Therapist, LMFT, PMH-C
Sierra Madre, CA 91024
I specialize in working with women and mothers who appear strong on the outside but feel overwhelmed, depleted, or disconnected within. Many are used to being the one others rely on, yet privately struggle with anxiety, constant mental load, and emotional exhaustion. They may find themselves overthinking, feeling on edge, or questioning themselves in ways they never used to. Many are navigating infertility, pregnancy, postpartum, motherhood, trauma, grief and loss, or major life transitions and are trying to find their footing again while holding so much for everyone else.
I specialize in working with women and mothers who appear strong on the outside but feel overwhelmed, depleted, or disconnected within. Many are used to being the one others rely on, yet privately struggle with anxiety, constant mental load, and emotional exhaustion. They may find themselves overthinking, feeling on edge, or questioning themselves in ways they never used to. Many are navigating infertility, pregnancy, postpartum, motherhood, trauma, grief and loss, or major life transitions and are trying to find their footing again while holding so much for everyone else.
(626) 784-4486 View (626) 784-4486

See more therapy options for Sierra Madre

How does your Therapist compare?

Number of Therapists in Sierra Madre, CA

100+

Average cost per session

$192

Therapists in Sierra Madre, CA who prioritize treating:

93% Anxiety
93% Social Anxiety
93% Health Anxiety
93% Driving Anxiety
91% Depression
78% Relationship Issues
74% Relationship Anxiety

Average years in practice

12 Years

Top 3 insurances accepted

79% Aetna
65% Optum
63% Cigna and Evernorth

How Therapists in Sierra Madre, CA see their clients

70% In Person and Online
30% Online Only

Gender breakdown

85% Female
15% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Sierra Madre?

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.