Therapists in Raleigh, NC

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Photo of Rebekah L Musselwhite, Clinical Social Work/Therapist in Raleigh, NC
Rebekah L Musselwhite
Clinical Social Work/Therapist, LCSWA, LCASA
Verified Verified
1 Endorsed
Raleigh, NC 27607
Accepting new clients- My therapy is informed by a dialectical model which means I can guide you to find balance of acceptance and change to focus on your goals and building a strong and happy life. My specialties include working with individuals with anxiety and depression type disorders. Young adults transitioning into adulthood and middle aged adults with life transitions. Individuals experiencing complex grief . Individuals who desire finding what is important to them in they’re marriage or domestic partnership to improve relationships. I also have a focus on individuals with multiple diagnosis including substance use disorders
Accepting new clients- My therapy is informed by a dialectical model which means I can guide you to find balance of acceptance and change to focus on your goals and building a strong and happy life. My specialties include working with individuals with anxiety and depression type disorders. Young adults transitioning into adulthood and middle aged adults with life transitions. Individuals experiencing complex grief . Individuals who desire finding what is important to them in they’re marriage or domestic partnership to improve relationships. I also have a focus on individuals with multiple diagnosis including substance use disorders
(919) 525-3818 View (919) 525-3818
Photo of David Mosca, Lic Clinical Mental Health Counselor Associate in Raleigh, NC
David Mosca
Lic Clinical Mental Health Counselor Associate, LCMHC-A, NCC
Verified Verified
2 Endorsed
Raleigh, NC 27612  (Online Only)
As a counselor, my professional identity is one of authenticity, curiosity, and empathy. I care deeply about helping my clients improve their lives. I believe that starts with the two of us forming a genuine connection so that I can best understand your personality, your worldview, and the problems you are facing – the world can be a tough place and we all have times when we could use someone to listen and understand us. I will repeatedly check in with you to assess your goals for therapy and make sure that we are making progress towards meeting those goals.
As a counselor, my professional identity is one of authenticity, curiosity, and empathy. I care deeply about helping my clients improve their lives. I believe that starts with the two of us forming a genuine connection so that I can best understand your personality, your worldview, and the problems you are facing – the world can be a tough place and we all have times when we could use someone to listen and understand us. I will repeatedly check in with you to assess your goals for therapy and make sure that we are making progress towards meeting those goals.
(919) 899-2902 View (919) 899-2902
Photo of Ameenah Ikram, Pre-Licensed Professional in Raleigh, NC
Ameenah Ikram
Pre-Licensed Professional, PsyD
Verified Verified
2 Endorsed
Raleigh, NC 27615
The greatest way to 'get over' something, is to go 'through' it in a compassionate and non-judgmental way. When life becomes challenging, you can oftentimes feel confused about where to turn. Perhaps you wish to discover the ways in which the past may be holding you back, better understand the reason why you're feeling stagnant in the present, and explore why the future may feel so intimidating for you. You may need the help of others to feel stable again and seeking therapy is a brave and courageous first step. You can discover new ways of living that feel fulfilling in the here and now. You deserve to feel better, and I can help.
The greatest way to 'get over' something, is to go 'through' it in a compassionate and non-judgmental way. When life becomes challenging, you can oftentimes feel confused about where to turn. Perhaps you wish to discover the ways in which the past may be holding you back, better understand the reason why you're feeling stagnant in the present, and explore why the future may feel so intimidating for you. You may need the help of others to feel stable again and seeking therapy is a brave and courageous first step. You can discover new ways of living that feel fulfilling in the here and now. You deserve to feel better, and I can help.
(919) 626-8940 x5 View (919) 626-8940 x5
Photo of Mary Woodson, Counselor in Raleigh, NC
Mary Woodson
Counselor, MS, LCAS, LCMHC, NCC
Verified Verified
1 Endorsed
Raleigh, NC 27607  (Online Only)
If you or your teenager can answer yes to ANY of these questions, let's schedule a time to meet conveniently online: Feeling hopeless or like things aren't going to get better? Having difficulty speaking up for yourself or communicating with others?Is it hard adjusting to change? Do you wish you had a clear plan towards reaching your goals? Do you deal with stress? Are you in an open, poly, or non-monogamous relationship (ENM)? Do you have negative thoughts or struggle with low self-esteem? Are you starting to use alcohol or drugs to cope with your problems and worried it may be getting out of control?
If you or your teenager can answer yes to ANY of these questions, let's schedule a time to meet conveniently online: Feeling hopeless or like things aren't going to get better? Having difficulty speaking up for yourself or communicating with others?Is it hard adjusting to change? Do you wish you had a clear plan towards reaching your goals? Do you deal with stress? Are you in an open, poly, or non-monogamous relationship (ENM)? Do you have negative thoughts or struggle with low self-esteem? Are you starting to use alcohol or drugs to cope with your problems and worried it may be getting out of control?
(919) 899-2841 View (919) 899-2841
Photo of Full Circle Wellness & Counseling PLLC, Marriage & Family Therapist in Raleigh, NC
Full Circle Wellness & Counseling PLLC
Marriage & Family Therapist, MA, LMFT
Verified Verified
3 Endorsed
Raleigh, NC 27609  (Online Only)
If you’re seeking the tools to cope with unexpected changes, want more fulfillment in your interpersonal relationships, or you’re struggling to see your self-worth, therapy can be the place you find your footing again. I provide support for clients experiencing complex trauma, anxiety, depression, social anxiety, racial identity stressors, and life cycle changes.
If you’re seeking the tools to cope with unexpected changes, want more fulfillment in your interpersonal relationships, or you’re struggling to see your self-worth, therapy can be the place you find your footing again. I provide support for clients experiencing complex trauma, anxiety, depression, social anxiety, racial identity stressors, and life cycle changes.
(336) 664-8116 View (336) 664-8116
Photo of Jocelyn Felter Brown, Counselor in Raleigh, NC
Jocelyn Felter Brown
Counselor, MEd, MPH, LCMHCA, NCC
Verified Verified
Raleigh, NC 27612  (Online Only)
So many people feel dissatisfied, directionless or frustrated with relationships, work/school, family/friends, or just life in general. Regardless of the issue(s) you may be dealing with (you may not even be sure what's wrong/not quite right), therapy can help you build a steadier, more satisfying life through non-judgmental, honest support, and a relationship you can count on. Based on your unique needs, we'll work through the hard stuff together with patience, honesty and compassion (and maybe even some humor), and develop a plan and a pace that will get you moving in a more positive direction.
So many people feel dissatisfied, directionless or frustrated with relationships, work/school, family/friends, or just life in general. Regardless of the issue(s) you may be dealing with (you may not even be sure what's wrong/not quite right), therapy can help you build a steadier, more satisfying life through non-judgmental, honest support, and a relationship you can count on. Based on your unique needs, we'll work through the hard stuff together with patience, honesty and compassion (and maybe even some humor), and develop a plan and a pace that will get you moving in a more positive direction.
(919) 759-5786 View (919) 759-5786
Photo of Amanda Wood, Clinical Social Work/Therapist in Raleigh, NC
Amanda Wood
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Raleigh, NC 27601  (Online Only)
Are you looking for a partner to support you as you tackle thoughts, feelings and life stressors that are getting in the way of your peace and happiness? If so, I hope I will be a good fit for you. I use the analogy that therapists are like shoes, you have to find the right fit. Feeling comfortable, seen, and safe allows for great progress to be made. I will ensure that our time together is focused on your goals. You set the pace and teach me how to best support you, because no one knows that better than you!
Are you looking for a partner to support you as you tackle thoughts, feelings and life stressors that are getting in the way of your peace and happiness? If so, I hope I will be a good fit for you. I use the analogy that therapists are like shoes, you have to find the right fit. Feeling comfortable, seen, and safe allows for great progress to be made. I will ensure that our time together is focused on your goals. You set the pace and teach me how to best support you, because no one knows that better than you!
(919) 823-9876 View (919) 823-9876
Photo of Alexandra Bonacci, Clinical Social Work/Therapist in Raleigh, NC
Alexandra Bonacci
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
1 Endorsed
Raleigh, NC 27607  (Online Only)
Accepting New Clients- I work with clients who are doing the very best they can taking care of their families, jobs, and other obligations. My client wants to be heard and supported, and that in and of itself can be very life-affirming and lead the way to self-care and personal success, however that looks like for you.
Accepting New Clients- I work with clients who are doing the very best they can taking care of their families, jobs, and other obligations. My client wants to be heard and supported, and that in and of itself can be very life-affirming and lead the way to self-care and personal success, however that looks like for you.
(919) 629-0846 View (919) 629-0846
Photo of Alexis Skelley, Clinical Social Work/Therapist in Raleigh, NC
Alexis Skelley
Clinical Social Work/Therapist, LCSW, LISW-CP, CDCES
Verified Verified
Raleigh, NC 27604  (Online Only)
Part of being human is experiencing a range of emotions... and they're not all rainbows and sparkles. Going through difficult times is a part of life. For most of us, we need or at least benefit from gaining support through those times. And, while it may be helpful to talk to a trusted friend or family member, therapy offers something different. Therapy gives you a totally safe place where you can explore your thoughts and behaviors with a trained professional who is non-biased. It is also a place where you can learn strategies to help you better deal with your challenges, set goals, and gain new perspectives. How great is that!?
Part of being human is experiencing a range of emotions... and they're not all rainbows and sparkles. Going through difficult times is a part of life. For most of us, we need or at least benefit from gaining support through those times. And, while it may be helpful to talk to a trusted friend or family member, therapy offers something different. Therapy gives you a totally safe place where you can explore your thoughts and behaviors with a trained professional who is non-biased. It is also a place where you can learn strategies to help you better deal with your challenges, set goals, and gain new perspectives. How great is that!?
(843) 920-6895 View (843) 920-6895
Photo of Willow Wilder, Clinical Social Work/Therapist in Raleigh, NC
Willow Wilder
Clinical Social Work/Therapist, LCSW
Verified Verified
6 Endorsed
Raleigh, NC 27607  (Online Only)
Accepting New Clients - My clinical practice mainly consists of fellow queer and neurodivergent folx who struggle with complex trauma. Common concerns include self-abandonment through people pleasing, exploring gender/sexual identity, executive dysfunction, immense shame/guilt, perfectionism, identifying community supports, and processing underlying traumatic experiences. My clients often come into session looking to better understand who they are and what really works for them. Many times they feel so detached from themselves and their own bodies that it has been hard to even know what they want from life or who they are
Accepting New Clients - My clinical practice mainly consists of fellow queer and neurodivergent folx who struggle with complex trauma. Common concerns include self-abandonment through people pleasing, exploring gender/sexual identity, executive dysfunction, immense shame/guilt, perfectionism, identifying community supports, and processing underlying traumatic experiences. My clients often come into session looking to better understand who they are and what really works for them. Many times they feel so detached from themselves and their own bodies that it has been hard to even know what they want from life or who they are
(919) 877-6269 View (919) 877-6269
Photo of Meagan Mulcahy, Marriage & Family Therapist in Raleigh, NC
Meagan Mulcahy
Marriage & Family Therapist, MS, LMFT
Verified Verified
1 Endorsed
Raleigh, NC 27609
I am a licensed Marriage and Family Therapist. I specialize in seeing adolescents and adults dealing with traumatic experiences, depression, anxiety, self-esteem, and behavioral, emotional and attachment difficulties. I often involves parents, family members and other supports in treatment due to her use of a systemic lens. I also enjoys working collaboratively with outside providers and helping clients identify additional resources that may be beneficial for their goals.
I am a licensed Marriage and Family Therapist. I specialize in seeing adolescents and adults dealing with traumatic experiences, depression, anxiety, self-esteem, and behavioral, emotional and attachment difficulties. I often involves parents, family members and other supports in treatment due to her use of a systemic lens. I also enjoys working collaboratively with outside providers and helping clients identify additional resources that may be beneficial for their goals.
(984) 208-2631 View (984) 208-2631
Photo of Elizabeth McInerney, Psychologist in Raleigh, NC
Elizabeth McInerney
Psychologist, PhD
Verified Verified
1 Endorsed
Raleigh, NC 27609
I am a counseling psychologist who offers individual and relationship therapy to adolescents and adults. I have expertise in working with those who are experiencing distress due to anxiety, depression, eating concerns, gender dysphoria, relationship conflict, sleep disorders, stress, and trauma. I work best with individuals who seek to deepen their awareness and to explore the nuanced complexities of life.
I am a counseling psychologist who offers individual and relationship therapy to adolescents and adults. I have expertise in working with those who are experiencing distress due to anxiety, depression, eating concerns, gender dysphoria, relationship conflict, sleep disorders, stress, and trauma. I work best with individuals who seek to deepen their awareness and to explore the nuanced complexities of life.
(919) 646-3795 x4 View (919) 646-3795 x4
Photo of Elizabeth Rasnick, Counselor in Raleigh, NC
Elizabeth Rasnick
Counselor, LCMHCA
Verified Verified
Raleigh, NC 27603
In my practice, I don’t just see symptoms; I see individuals grappling with complex emotions and experiences. I understand the weight of your struggles and the impact they have on your daily life. That’s why I take a holistic and systemic approach, acknowledging the intricate connection between your thoughts, behaviors, and emotions, all within the context of your unique past and present circumstances.
In my practice, I don’t just see symptoms; I see individuals grappling with complex emotions and experiences. I understand the weight of your struggles and the impact they have on your daily life. That’s why I take a holistic and systemic approach, acknowledging the intricate connection between your thoughts, behaviors, and emotions, all within the context of your unique past and present circumstances.
(984) 206-3194 View (984) 206-3194
Photo of Corey Myrick, Clinical Social Work/Therapist in Raleigh, NC
Corey Myrick
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Raleigh, NC 27615
My clinical experience includes specialization in various theoretical approaches, each of which is client-centered, solution-focused, and holistic in nature. Common areas of clinical focus include: anxiety, behavioral disorders, adjustment difficulties, ADHD, and depression. My clientele includes teens (16 and up), young adults, men, women, and those who identify as LGBTQ+. I have a specific interest in working with young adults and college students but appreciate working with clients of all ages.
My clinical experience includes specialization in various theoretical approaches, each of which is client-centered, solution-focused, and holistic in nature. Common areas of clinical focus include: anxiety, behavioral disorders, adjustment difficulties, ADHD, and depression. My clientele includes teens (16 and up), young adults, men, women, and those who identify as LGBTQ+. I have a specific interest in working with young adults and college students but appreciate working with clients of all ages.
(919) 762-6849 View (919) 762-6849
Photo of Cynthia L Babits, Clinical Social Work/Therapist in Raleigh, NC
Cynthia L Babits
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
1 Endorsed
Raleigh, NC 27615
Psychotherapy is the opportunity to learn about yourself, and to make changes you haven't been able to make before. When we understand ourselves we can change how we relate to ourselves and others, we can work toward meaningful accomplishments that connect with our deepest values. Therapy can help you to become more effective, stronger, and more fulfilled, as you become the person you want to be. If you're looking for guidance through a challenging situation or you're ready to move in a new direction in your life, I look forward to working with you to achieve your goals.
Psychotherapy is the opportunity to learn about yourself, and to make changes you haven't been able to make before. When we understand ourselves we can change how we relate to ourselves and others, we can work toward meaningful accomplishments that connect with our deepest values. Therapy can help you to become more effective, stronger, and more fulfilled, as you become the person you want to be. If you're looking for guidance through a challenging situation or you're ready to move in a new direction in your life, I look forward to working with you to achieve your goals.
(919) 255-8243 View (919) 255-8243
Photo of Peggy Widener, Clinical Social Work/Therapist in Raleigh, NC
Peggy Widener
Clinical Social Work/Therapist, LCSW
Verified Verified
Raleigh, NC 27615
Feeling stressed, overwhelmed, unhappy or maybe just lost? Has your marriage gotten too hard? You are not alone. We all encounter difficult times throughout life and sometimes we need help. It is my belief that everyone can achieve the happiness that they desire but sometimes obstacles stand in our way. With a variety of techniques and support you will discover how to live your life to its greatest potential. My office will be a safe and secure place for you to focus on yourself and the goals that you want to achieve.
Feeling stressed, overwhelmed, unhappy or maybe just lost? Has your marriage gotten too hard? You are not alone. We all encounter difficult times throughout life and sometimes we need help. It is my belief that everyone can achieve the happiness that they desire but sometimes obstacles stand in our way. With a variety of techniques and support you will discover how to live your life to its greatest potential. My office will be a safe and secure place for you to focus on yourself and the goals that you want to achieve.
(919) 646-3288 View (919) 646-3288
Photo of Valerie Hartzog Thorn, Licensed Clinical Mental Health Counselor in Raleigh, NC
Valerie Hartzog Thorn
Licensed Clinical Mental Health Counselor, MA, LCMHC
Verified Verified
1 Endorsed
Raleigh, NC 27607
The pain, the trauma, the struggle is real. I desire to walk with you to heal the hurt, redeem the loss, & begin to allow yourself to live in the moment. Start a new beginning today, you do not have to keep living in the past. I honor a client's personal and spiritual values and strive to integrate faith and psychology's best practices. My special interests and experience include working with adults, adolescents, with anxiety, depression & trauma. My theoretical approach uses evidenced based practices, integrating Person Centered, Trauma informed Care, Cognitive and Dialectical Behavioral therapy and Solution Focused techniques.
The pain, the trauma, the struggle is real. I desire to walk with you to heal the hurt, redeem the loss, & begin to allow yourself to live in the moment. Start a new beginning today, you do not have to keep living in the past. I honor a client's personal and spiritual values and strive to integrate faith and psychology's best practices. My special interests and experience include working with adults, adolescents, with anxiety, depression & trauma. My theoretical approach uses evidenced based practices, integrating Person Centered, Trauma informed Care, Cognitive and Dialectical Behavioral therapy and Solution Focused techniques.
(919) 646-5778 View (919) 646-5778
Photo of Patricia Lytwyn, Counselor in Raleigh, NC
Patricia Lytwyn
Counselor, LCMHC
Verified Verified
Raleigh, NC 27607
Patty Lytwyn is a Licensed Clinical Mental Health Counselor Associate with over four years of experience specializing in depression, anxiety, ADD/ADHD, trauma, mid-life transitions, and couples' issues, Patty treats patients between the ages of 11 and 70 utilizing Person Centered and Cognitive Behavioral Therapy. Patty has extensive experience counseling older children, adolescents, adults, seniors, families, and couples in both clinical and outpatient settings.
Patty Lytwyn is a Licensed Clinical Mental Health Counselor Associate with over four years of experience specializing in depression, anxiety, ADD/ADHD, trauma, mid-life transitions, and couples' issues, Patty treats patients between the ages of 11 and 70 utilizing Person Centered and Cognitive Behavioral Therapy. Patty has extensive experience counseling older children, adolescents, adults, seniors, families, and couples in both clinical and outpatient settings.
(919) 849-5938 View (919) 849-5938
Photo of Elise Davis, Licensed Clinical Mental Health Counselor in Raleigh, NC
Elise Davis
Licensed Clinical Mental Health Counselor, LCMHC
Verified Verified
Raleigh, NC 27616  (Online Only)
There are times in life where we all feel exposed, vulnerable, and unsure. Life can seem scary, frustrating, hopeless, and chaotic. We forget who we are or admit we don't know where we are going. Life experiences and our mindset can stop us from living. There are times when emotions run the show and lead to choices that make things worse.
There are times in life where we all feel exposed, vulnerable, and unsure. Life can seem scary, frustrating, hopeless, and chaotic. We forget who we are or admit we don't know where we are going. Life experiences and our mindset can stop us from living. There are times when emotions run the show and lead to choices that make things worse.
(984) 538-9965 View (984) 538-9965
Photo of Debra Jaffe, Clinical Social Work/Therapist in Raleigh, NC
Debra Jaffe
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Raleigh, NC 27609  (Online Only)
Discover meaningful change through 32 years of therapeutic experience. As a dedicated therapist, I understand the courage it takes to seek help. I'm committed to tailoring my approach to suit your needs.
Discover meaningful change through 32 years of therapeutic experience. As a dedicated therapist, I understand the courage it takes to seek help. I'm committed to tailoring my approach to suit your needs.
(919) 646-6419 View (919) 646-6419

How does your Therapist compare?

Number of Therapists in Raleigh, NC

2,000+

Average cost per session

$140

Therapists in Raleigh, NC who prioritize treating:

93% Anxiety
88% Depression
78% Self Esteem
76% Relationship Issues
74% Coping Skills
73% Stress
66% Life Transitions

Average years in practice

10 Years

Top 3 insurances accepted

85% BlueCross and BlueShield
72% Aetna
55% Cigna and Evernorth

How Therapists in Raleigh, NC see their clients

60% In Person and Online
40% Online Only

Gender breakdown

84% Female
15% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Raleigh?

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.