Therapists in Chattanooga, TN

Photo of Jaime Butler, Pre-Licensed Professional in Chattanooga, TN
Jaime Butler
Pre-Licensed Professional
Verified Verified
Chattanooga, TN 37404
I am a neuro-inclusive/neurodiversity-affirming pre-licensed counselor that enjoys working with autistic folks. I have experience providing support for a wide range of ages and autistic experiences- from those who are newly diagnosed and navigating that process to those who are struggling with the impacts of having to mask in order to survive a world not built for them. Regardless of whether or not you have a formal diagnosis, I would love to be a resource for you.
I am a neuro-inclusive/neurodiversity-affirming pre-licensed counselor that enjoys working with autistic folks. I have experience providing support for a wide range of ages and autistic experiences- from those who are newly diagnosed and navigating that process to those who are struggling with the impacts of having to mask in order to survive a world not built for them. Regardless of whether or not you have a formal diagnosis, I would love to be a resource for you.
(423) 537-4637 View (423) 537-4637
Photo of Megan Tresh, Marriage & Family Therapist Intern in Chattanooga, TN
Megan Tresh
Marriage & Family Therapist Intern, MS
Verified Verified
3 Endorsed
Chattanooga, TN 37405
Embracing life's uncertainties, transitions, & unmet expectations can be challenging, but we are able to move forward with meaning & purpose. Sometimes building a level of resilience & mental fortitude is required for us to progress. By using an underlying attachment-based approach, I’m able to provide therapeutic services that are safe, authentic, & non-judgemental to allow for healing & growth. I have found that tailoring the modalities used to each client provides positive outcomes in various situations. EMDR, exposure & response prevention (ERP), experiential activities, & play therapy are among those that I am trained in.
Embracing life's uncertainties, transitions, & unmet expectations can be challenging, but we are able to move forward with meaning & purpose. Sometimes building a level of resilience & mental fortitude is required for us to progress. By using an underlying attachment-based approach, I’m able to provide therapeutic services that are safe, authentic, & non-judgemental to allow for healing & growth. I have found that tailoring the modalities used to each client provides positive outcomes in various situations. EMDR, exposure & response prevention (ERP), experiential activities, & play therapy are among those that I am trained in.
(423) 370-0124 View (423) 370-0124
Photo of Dr. Lorrie Byrd Slater, Counselor in Chattanooga, TN
Dr. Lorrie Byrd Slater
Counselor, PhD, LMFT, LPC, MHSP
Verified Verified
Chattanooga, TN 37404
Life can become overwhelming at times. I consider it a privilege to walk through difficult parts of your journey with you. Life transitions, family distress and conflict, abuse, divorce, anxiety, depression, as well as child and adolescent behavioral concerns, can leave you feeling helpless. I am honored to help you find your strength to cope in times of pain and suffering.
Life can become overwhelming at times. I consider it a privilege to walk through difficult parts of your journey with you. Life transitions, family distress and conflict, abuse, divorce, anxiety, depression, as well as child and adolescent behavioral concerns, can leave you feeling helpless. I am honored to help you find your strength to cope in times of pain and suffering.
(423) 437-0859 View (423) 437-0859
Photo of Sarah Otis, Psychologist in Chattanooga, TN
Sarah Otis
Psychologist, PhD
Verified Verified
3 Endorsed
Chattanooga, TN 37411
Dr. Sarah Otis provides psychological and psychoeducational evaluations for a wide range of psychiatric and neurodevelopmental disorders including ADHD, learning disability, intellectual disability, autism, giftedness, and emotional/behavioral difficulties. She is passionate about helping others navigate cognitive and/or emotional difficulties by taking a strengths based approach and supporting growth through empirically supported recommendations and treatment. Sarah also provides psychotherapy and utilizes an integrative approach that is scientifically informed and psychodynamically influenced.
Dr. Sarah Otis provides psychological and psychoeducational evaluations for a wide range of psychiatric and neurodevelopmental disorders including ADHD, learning disability, intellectual disability, autism, giftedness, and emotional/behavioral difficulties. She is passionate about helping others navigate cognitive and/or emotional difficulties by taking a strengths based approach and supporting growth through empirically supported recommendations and treatment. Sarah also provides psychotherapy and utilizes an integrative approach that is scientifically informed and psychodynamically influenced.
(423) 919-9126 View (423) 919-9126
Photo of Rachael Shepard, Marriage & Family Therapist in Chattanooga, TN
Rachael Shepard
Marriage & Family Therapist, MA, MFT-I
Verified Verified
2 Endorsed
Chattanooga, TN 37408
Wanting to feel confident, content, and connected? It can feel so challenging and helpless when faced with anxiety, stress, and internal negative thoughts. If you are experiencing anxiety, depression, feeling stuck, or recovering from people-pleasing or co-dependent relationships, I would love to collaborate with you towards healing. Often our negative thoughts and beliefs about ourselves impact our relationships. If this describes your story and you are seeking a safe place to process, desire to be heard, and are willing to learn tools and skills to make change you're in the right place.
Wanting to feel confident, content, and connected? It can feel so challenging and helpless when faced with anxiety, stress, and internal negative thoughts. If you are experiencing anxiety, depression, feeling stuck, or recovering from people-pleasing or co-dependent relationships, I would love to collaborate with you towards healing. Often our negative thoughts and beliefs about ourselves impact our relationships. If this describes your story and you are seeking a safe place to process, desire to be heard, and are willing to learn tools and skills to make change you're in the right place.
(423) 228-8262 View (423) 228-8262
Photo of Lynn Helwig, Licensed Professional Counselor in Chattanooga, TN
Lynn Helwig
Licensed Professional Counselor, MA , LPC, MHSP
Verified Verified
2 Endorsed
Chattanooga, TN 37415
Waitlist for new clients
Are you struggling to heal after leaving a toxic relationship? Do you feel as though you’ve lost yourself or you don’t even know who you are? Is it difficult to express your feelings or thoughts? Perhaps you are experiencing tension or communication problems in your relationships? If you have, or are experiencing any of these issues, I would be honored to walk with you and help you navigate your way to confidence, freedom and healing. I work with adults and approach therapy from a Christian worldview. I integrate faith into the counseling process by request.
Are you struggling to heal after leaving a toxic relationship? Do you feel as though you’ve lost yourself or you don’t even know who you are? Is it difficult to express your feelings or thoughts? Perhaps you are experiencing tension or communication problems in your relationships? If you have, or are experiencing any of these issues, I would be honored to walk with you and help you navigate your way to confidence, freedom and healing. I work with adults and approach therapy from a Christian worldview. I integrate faith into the counseling process by request.
(423) 481-8987 View (423) 481-8987
Photo of Taylor Bowman, Marriage & Family Therapist in Chattanooga, TN
Taylor Bowman
Marriage & Family Therapist, LMFT
Verified Verified
2 Endorsed
Chattanooga, TN 37403
Many of us struggle with the tendency to isolate ourselves when we are in pain. We experience shame and guilt at the prospect of our stories being heard by others. So instead of leaning in to one another, we push away, leaving us unseen, forgotten and lonely. In spite of our fears, I believe we all have a deep, innate desire to be known and accepted in our stories, and it takes great courage to push past what we are afraid of to find the freedom that comes with sharing who we are.
Many of us struggle with the tendency to isolate ourselves when we are in pain. We experience shame and guilt at the prospect of our stories being heard by others. So instead of leaning in to one another, we push away, leaving us unseen, forgotten and lonely. In spite of our fears, I believe we all have a deep, innate desire to be known and accepted in our stories, and it takes great courage to push past what we are afraid of to find the freedom that comes with sharing who we are.
(423) 406-6783 View (423) 406-6783
Photo of Holly Meredith, Pre-Licensed Professional in Chattanooga, TN
Holly Meredith
Pre-Licensed Professional, MA
Verified Verified
1 Endorsed
Chattanooga, TN 37419
I utilize an eclectic approach to counseling, drawing from a range of theories and techniques to effectively address the diverse needs of my clients. I create a safe and non-judgmental space for individuals to process various challenges and recognize the unique needs of each person. By tailoring my counseling techniques to meet their specific circumstances, I guide my clients toward healing, growth, and improved well-being with empathy and care.
I utilize an eclectic approach to counseling, drawing from a range of theories and techniques to effectively address the diverse needs of my clients. I create a safe and non-judgmental space for individuals to process various challenges and recognize the unique needs of each person. By tailoring my counseling techniques to meet their specific circumstances, I guide my clients toward healing, growth, and improved well-being with empathy and care.
(423) 451-8576 View (423) 451-8576
Photo of Anna Glass Clower, Pre-Licensed Professional in Chattanooga, TN
Anna Glass Clower
Pre-Licensed Professional, LPC
Verified Verified
3 Endorsed
Chattanooga, TN 37405
"Well, this isn’t working! What do I do now?" If you are wondering this, I welcome whatever you have to discuss. I love to see a client walk into the room, bursting with the issues carried on the heart, and experience the relief that comes from finally sharing these burdens out loud in a safe space. I see mostly women and female adolescents, plus a few men who want to dig deep. I work best with people who are ready to explore, looking for change, but aren't sure of how to get there.
"Well, this isn’t working! What do I do now?" If you are wondering this, I welcome whatever you have to discuss. I love to see a client walk into the room, bursting with the issues carried on the heart, and experience the relief that comes from finally sharing these burdens out loud in a safe space. I see mostly women and female adolescents, plus a few men who want to dig deep. I work best with people who are ready to explore, looking for change, but aren't sure of how to get there.
(423) 793-3062 View (423) 793-3062
Photo of Jas Sullivan Milam, Art Therapist in Chattanooga, TN
Jas Sullivan Milam
Art Therapist, ATR/BC
Verified Verified
1 Endorsed
Chattanooga, TN 37404
Have you tried talk therapy but still feel stuck? I am an artist and art therapist with over 35 years of personal recovery. My background is in 12 Step models, Jungian psychology, family systems and lots of art making experience. YOU DO NOT NEED ART TRAINING OR TALENT TO BENEFIT FROM ART THERAPY. Because art is a right-brained function, art therapy can be especially useful to people who are "too smart" for talk therapy. I have also begun using art to process trauma as well. Interested? Schedule an assessment!
Have you tried talk therapy but still feel stuck? I am an artist and art therapist with over 35 years of personal recovery. My background is in 12 Step models, Jungian psychology, family systems and lots of art making experience. YOU DO NOT NEED ART TRAINING OR TALENT TO BENEFIT FROM ART THERAPY. Because art is a right-brained function, art therapy can be especially useful to people who are "too smart" for talk therapy. I have also begun using art to process trauma as well. Interested? Schedule an assessment!
(423) 708-4228 View (423) 708-4228
Photo of Ryan McNealy Morehead, Licensed Professional Counselor in Chattanooga, TN
Ryan McNealy Morehead
Licensed Professional Counselor, LPC, MHSP
Verified Verified
1 Endorsed
Chattanooga, TN 37408
Are you struggling to help your child manage their emotions or behavior? Does your child seem moody, angry, sad, or anxious? I can help. Working with children and adolescents struggling with low mood, anger and anxiety is my specialty. My practice of counseling blends cognitive behavioral, solution focused and reality based therapy in an way that meets the individual needs of each person.
Are you struggling to help your child manage their emotions or behavior? Does your child seem moody, angry, sad, or anxious? I can help. Working with children and adolescents struggling with low mood, anger and anxiety is my specialty. My practice of counseling blends cognitive behavioral, solution focused and reality based therapy in an way that meets the individual needs of each person.
(423) 896-1141 View (423) 896-1141
Photo of Lindsay Keiss, Pre-Licensed Professional in Chattanooga, TN
Lindsay Keiss
Pre-Licensed Professional, MA
Verified Verified
Chattanooga, TN 37408
I am passionate about walking alongside individuals who feel beat down and weary from life’s burdens. Life is not easy, but having someone with an outside view can really help provide the clarity and insight we need. If you are hurting, struggling to stay hopeful, or having trouble finding direction, I would be honored to hear your story and walk with you towards hope and healing.
I am passionate about walking alongside individuals who feel beat down and weary from life’s burdens. Life is not easy, but having someone with an outside view can really help provide the clarity and insight we need. If you are hurting, struggling to stay hopeful, or having trouble finding direction, I would be honored to hear your story and walk with you towards hope and healing.
(423) 537-4844 View (423) 537-4844
Kindbridge Behavioral Health
Counselor, LPC
Verified Verified
Chattanooga, TN 37402
Kindbridge is building the largest nationwide network of mental health treatment providers with a focus on gambling and gaming disorders in the United States. Our goal is to provide a tailored telemedicine patient experience that delivers top patient care and the highest quality recovery outcomes.
Kindbridge is building the largest nationwide network of mental health treatment providers with a focus on gambling and gaming disorders in the United States. Our goal is to provide a tailored telemedicine patient experience that delivers top patient care and the highest quality recovery outcomes.
(423) 919-8379 View (423) 919-8379
Photo of Karen Casey, Licensed Professional Counselor in Chattanooga, TN
Karen Casey
Licensed Professional Counselor, LPC, MHSP
Verified Verified
Chattanooga, TN 37403
Not accepting new clients
I have 18 years experience working with a variety of concerns including : relationship issues, disordered eating, body image struggles, substance addiction, life transitions, grief and loss and individuation from family of origin experiences. I have a special interest in helping couples develop deeper emotional connections based on attachment, vulnerability, and authenticity and recovering from losses such as the impact of addiction, fertility challenges, emotional distance, and conflict in communication. I enjoy helping others explore their relationship with food and eating behaviors.
I have 18 years experience working with a variety of concerns including : relationship issues, disordered eating, body image struggles, substance addiction, life transitions, grief and loss and individuation from family of origin experiences. I have a special interest in helping couples develop deeper emotional connections based on attachment, vulnerability, and authenticity and recovering from losses such as the impact of addiction, fertility challenges, emotional distance, and conflict in communication. I enjoy helping others explore their relationship with food and eating behaviors.
(423) 564-4348 View (423) 564-4348
Photo of Jordan Harpley, Licensed Professional Counselor in Chattanooga, TN
Jordan Harpley
Licensed Professional Counselor, LPC, MHSP, NCC
Verified Verified
2 Endorsed
Chattanooga, TN 37421
Not accepting new clients
Welcome! I am a Licensed Professional Counselor who specializes in counseling children, teenagers, and young adults. I graduated from the University of Tennessee at Chattanooga in 2013 with a Master's Degree in Clinical Mental Health Counseling. I spent the first 8 years of my career as a trauma counselor in a residential facility for children in state custody and started my private practice in January 2020. I use creative techniques to connect with my clients and practice from a foundation of Cognitive Behavioral Therapy and Dialectical Behavior Therapy.
Welcome! I am a Licensed Professional Counselor who specializes in counseling children, teenagers, and young adults. I graduated from the University of Tennessee at Chattanooga in 2013 with a Master's Degree in Clinical Mental Health Counseling. I spent the first 8 years of my career as a trauma counselor in a residential facility for children in state custody and started my private practice in January 2020. I use creative techniques to connect with my clients and practice from a foundation of Cognitive Behavioral Therapy and Dialectical Behavior Therapy.
(423) 271-3606 View (423) 271-3606
Photo of Kendal McDaniel, Pre-Licensed Professional in Chattanooga, TN
Kendal McDaniel
Pre-Licensed Professional, MA, MFTI
Verified Verified
Chattanooga, TN 37405
As a member of the LGBTQ+ community, I am passionate about working with our community and can personally relate to how religious, childhood, relational, and societal trauma can impact sexuality and sexual orientation. Sexuality is a unique spectrum and is a beautiful part of who we are. In therapy together, you will find an accepting and safe space to explore all questions related to sexuality, sexual orientation and gender, non-traditional relationships, and sense of self, all with compassion and care. At Affirming Therapy Services, you are free to be who you are and to continue to discover your most authentic self.
As a member of the LGBTQ+ community, I am passionate about working with our community and can personally relate to how religious, childhood, relational, and societal trauma can impact sexuality and sexual orientation. Sexuality is a unique spectrum and is a beautiful part of who we are. In therapy together, you will find an accepting and safe space to explore all questions related to sexuality, sexual orientation and gender, non-traditional relationships, and sense of self, all with compassion and care. At Affirming Therapy Services, you are free to be who you are and to continue to discover your most authentic self.
(423) 592-8149 View (423) 592-8149
Photo of Arianne Brigner At Chattanooga Dbt, Licensed Professional Counselor in Chattanooga, TN
Arianne Brigner At Chattanooga Dbt
Licensed Professional Counselor, LPC, MHSP
Verified Verified
1 Endorsed
Chattanooga, TN 37411
Do you experience strong emotions that sometimes overwhelm you? As a result, you do things to cope that you later regret. In the moment, you don’t know what else to do. You’ve tried to get help. Nothing seems to work. “Talk therapy” doesn’t cut it. Medications don’t do the trick. Self-help books are garbage. At this point, you’d do anything to have a different life. To be different. To feel different. Well. You’ve finally come to the right place. We work with people just like you. In fact, we LOVE working with people just like you. It’s our passion. We help you create a life you can love.
Do you experience strong emotions that sometimes overwhelm you? As a result, you do things to cope that you later regret. In the moment, you don’t know what else to do. You’ve tried to get help. Nothing seems to work. “Talk therapy” doesn’t cut it. Medications don’t do the trick. Self-help books are garbage. At this point, you’d do anything to have a different life. To be different. To feel different. Well. You’ve finally come to the right place. We work with people just like you. In fact, we LOVE working with people just like you. It’s our passion. We help you create a life you can love.
(423) 402-8649 View (423) 402-8649
Photo of Tori Ballard, Pre-Licensed Professional in Chattanooga, TN
Tori Ballard
Pre-Licensed Professional, MA, NCC
Verified Verified
4 Endorsed
Chattanooga, TN 37405
Through the ups and downs of life, one thing remains a constant— you. I help my clients foster a relationship with themselves with a sense of curiosity, acceptance, and grace. Life can be tough and confusing, but you are strong and resilient. I want to walk alongside you, hear your story, and offer a safe space for expression and exploration. It is my belief that people make sense- the person who starves themselves, or isolates when sad, or can’t find relief from that nervous feeling in their stomach, all make sense. You are not alone. Let’s walk towards healing together.
Through the ups and downs of life, one thing remains a constant— you. I help my clients foster a relationship with themselves with a sense of curiosity, acceptance, and grace. Life can be tough and confusing, but you are strong and resilient. I want to walk alongside you, hear your story, and offer a safe space for expression and exploration. It is my belief that people make sense- the person who starves themselves, or isolates when sad, or can’t find relief from that nervous feeling in their stomach, all make sense. You are not alone. Let’s walk towards healing together.
(423) 205-6851 View (423) 205-6851
Photo of Bevin Dunn, Licensed Professional Counselor in Chattanooga, TN
Bevin Dunn
Licensed Professional Counselor, MA, LPC, MHSP, NCC
Verified Verified
4 Endorsed
Chattanooga, TN 37404
It takes such courage to open ourselves to the possibility of healing when we have been hurt. But the fullness of life that grows out of engaging in the healing process is something I continue to experience personally in my own life and professionally with my clients. While we receive our deepest wounds in relationships, it is in relationships that we can also experience the deepest healing. Some of the bravest people I have ever met are the individuals I sit with in the counseling office, and I commend you for starting the process by looking for a counselor.
It takes such courage to open ourselves to the possibility of healing when we have been hurt. But the fullness of life that grows out of engaging in the healing process is something I continue to experience personally in my own life and professionally with my clients. While we receive our deepest wounds in relationships, it is in relationships that we can also experience the deepest healing. Some of the bravest people I have ever met are the individuals I sit with in the counseling office, and I commend you for starting the process by looking for a counselor.
(423) 525-8705 View (423) 525-8705
Photo of Christy Falco, Marriage & Family Therapist in Chattanooga, TN
Christy Falco
Marriage & Family Therapist, MS, LMFT
Verified Verified
1 Endorsed
Chattanooga, TN 37408
Whether you are a new mother, working mom of three, a teenager striking out socially, a single man struggling with failed relationships, an "empty nester" trying to figure out what comes next or you are facing challenges with your partner, things can seem just so hard. The stresses and strains of life sometimes overwhelm our ability to cope. That is when counseling can provide restorative benefits.
Whether you are a new mother, working mom of three, a teenager striking out socially, a single man struggling with failed relationships, an "empty nester" trying to figure out what comes next or you are facing challenges with your partner, things can seem just so hard. The stresses and strains of life sometimes overwhelm our ability to cope. That is when counseling can provide restorative benefits.
(423) 205-1259 View (423) 205-1259

How does your Therapist compare?

Number of Therapists in Chattanooga, TN

400+

Average cost per session

$120

Therapists in Chattanooga, TN who prioritize treating:

93% Anxiety
86% Depression
81% Relationship Issues
79% Self Esteem
76% Trauma and PTSD
75% Coping Skills
74% Stress

Average years in practice

9 Years

Top 3 insurances accepted

80% Cigna and Evernorth
71% Aetna
63% UnitedHealthcare UHC | UBH

How Therapists in Chattanooga, TN see their clients

75% In Person and Online
25% Online Only

Gender breakdown

79% Female
20% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Chattanooga?

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.