Therapists in Spencer, NY

Photo of Andy Davenport, Clinical Social Work/Therapist in Spencer, NY
Andy Davenport
Clinical Social Work/Therapist, LCSW
Verified Verified
Spencer, NY 14883  (Online Only)
I am looking for a client who, like myself, is willing to learn and grow. Our lives are ever changing and having someone to help guide you through those slings and arrows of life is who I hope to be. I specialize in EMDR, play/movement based therapy with CBT principles, and parent/child relationships.
I am looking for a client who, like myself, is willing to learn and grow. Our lives are ever changing and having someone to help guide you through those slings and arrows of life is who I hope to be. I specialize in EMDR, play/movement based therapy with CBT principles, and parent/child relationships.
(607) 246-7054 View (607) 246-7054
Photo of Jeffrey Caris, Counselor in Spencer, NY
Jeffrey Caris
Counselor, MA, LMHC, QHP
Verified Verified
Spencer, NY 14883
There is something very healing and relieving about sharing ones struggles with an experienced therapist. Many of my clients begin feeling better after just one session because of this dynamic. Therapy was always intended to help someone experience relief from that which is troubling them. My therapy style is professional, relatable, and empathic. I consider it a privilege to be able to join with you and to be a part of your healing journey.
There is something very healing and relieving about sharing ones struggles with an experienced therapist. Many of my clients begin feeling better after just one session because of this dynamic. Therapy was always intended to help someone experience relief from that which is troubling them. My therapy style is professional, relatable, and empathic. I consider it a privilege to be able to join with you and to be a part of your healing journey.
(607) 271-6884 View (607) 271-6884
Photo of Alison Beach, Clinical Social Work/Therapist in Spencer, NY
Alison Beach
Clinical Social Work/Therapist, MA, MSW, LCSW
Verified Verified
Spencer, NY 14883  (Online Only)
I am currently not accepting new clients. If you would like to discuss waitlist opportunities for winter/spring 2024, please contact me. For continuity of services during academic breaks, I am also licensed to practice in Michigan, New Jersey, and Pennsylvania in addition to New York State.
I am currently not accepting new clients. If you would like to discuss waitlist opportunities for winter/spring 2024, please contact me. For continuity of services during academic breaks, I am also licensed to practice in Michigan, New Jersey, and Pennsylvania in addition to New York State.
(607) 882-6106 View (607) 882-6106

More Therapists Nearby

Photo of Rob Hovey, Clinical Social Work/Therapist in Spencer, NY
Rob Hovey
Clinical Social Work/Therapist, LCSWR
Verified Verified
Danby, NY 14883  (Online Only)
I AM CURRENTLY. UNABLE TO ACCEPT NEW CLIENTS Seeing a therapist -- this is not an easy step you’re considering. Putting your most vulnerable thoughts and feelings in the hands of a stranger takes some courage and a bit of a leap of faith. Whether you’re feeling anxious or depressed, or are in a troubled marriage or relationship, or struggling with issues that have no label, you’re probably feeling stuck. Stuck is when people call a therapist. It’s after they have tried everything: waiting for things to get better, talking to friends or relatives, or reading self-help books.
I AM CURRENTLY. UNABLE TO ACCEPT NEW CLIENTS Seeing a therapist -- this is not an easy step you’re considering. Putting your most vulnerable thoughts and feelings in the hands of a stranger takes some courage and a bit of a leap of faith. Whether you’re feeling anxious or depressed, or are in a troubled marriage or relationship, or struggling with issues that have no label, you’re probably feeling stuck. Stuck is when people call a therapist. It’s after they have tried everything: waiting for things to get better, talking to friends or relatives, or reading self-help books.
(607) 882-6465 View (607) 882-6465
Photo of Celeste Froehlich, Clinical Social Work/Therapist in Spencer, NY
Celeste Froehlich
Clinical Social Work/Therapist, MA, LCSW-R
Verified Verified
6 Endorsed
Danby, NY 14883
Not accepting new clients
No openings at this time- please check back in a month or so! We work with individual adult and adolescent clients of all ages, races, cultures, LGBTQ, etc., to rediscover genuine strength, vitality, and empowerment. Are you struggling with work, relationships, or past trauma? I offer a safe, nonjudgemental, compassionate atmosphere, and listen deeply. I use relational/experiential and mindfulness-based modalities. I believe therapy sessions shouldn't be just talking about feelings, but instead having a new experience, so you leave each session feeling different, better. Together, we forge new pathways for lasting healing.
No openings at this time- please check back in a month or so! We work with individual adult and adolescent clients of all ages, races, cultures, LGBTQ, etc., to rediscover genuine strength, vitality, and empowerment. Are you struggling with work, relationships, or past trauma? I offer a safe, nonjudgemental, compassionate atmosphere, and listen deeply. I use relational/experiential and mindfulness-based modalities. I believe therapy sessions shouldn't be just talking about feelings, but instead having a new experience, so you leave each session feeling different, better. Together, we forge new pathways for lasting healing.
(607) 305-4528 View (607) 305-4528
Photo of Amy Lee Jacobs, Clinical Social Work/Therapist in Spencer, NY
Amy Lee Jacobs
Clinical Social Work/Therapist, LCSW
Verified Verified
Willseyville, NY 13864  (Online Only)
Hi and thanks for reading my profile. My name is Amy and I am a LCSW with almost 40 years of experience. I enjoy working with adults and couples who are experiencing trauma, adversity, anxiety, alienation and depression as there are many approaches and ways to heal. I use an integrative approach and tailor it based on what what you are comfortable with and willing to explore. I always encourage and respect your boundaries. Please email if you would like a free 15" phone consult to see if we are a good fit!
Hi and thanks for reading my profile. My name is Amy and I am a LCSW with almost 40 years of experience. I enjoy working with adults and couples who are experiencing trauma, adversity, anxiety, alienation and depression as there are many approaches and ways to heal. I use an integrative approach and tailor it based on what what you are comfortable with and willing to explore. I always encourage and respect your boundaries. Please email if you would like a free 15" phone consult to see if we are a good fit!
(607) 258-9281 View (607) 258-9281
Photo of Lezlie Namaste, Clinical Social Work/Therapist in Spencer, NY
Lezlie Namaste
Clinical Social Work/Therapist, LCSW-R
Verified Verified
5 Endorsed
Ithaca, NY 14850
I'd like to support you to discover your strengths, resiliency and feel empowered in your life, schooling and relationships. Together, in a warm, safe, collaborative environment, we create a positive path towards your well-being to deal with anxiety, depression, procrastination and stress. Utilizing your inherent strengths and coping strategies with new successful skills and approaches, we will uncover negative thought patterns or behaviors, stuck places, and create new pathways. Reconnecting with your healthy self, we will navigate through present transitions, pain or loss to transform your connection with yourself and others.
I'd like to support you to discover your strengths, resiliency and feel empowered in your life, schooling and relationships. Together, in a warm, safe, collaborative environment, we create a positive path towards your well-being to deal with anxiety, depression, procrastination and stress. Utilizing your inherent strengths and coping strategies with new successful skills and approaches, we will uncover negative thought patterns or behaviors, stuck places, and create new pathways. Reconnecting with your healthy self, we will navigate through present transitions, pain or loss to transform your connection with yourself and others.
(607) 354-3063 View (607) 354-3063
Photo of Ester Edelman, Clinical Social Work/Therapist in Spencer, NY
Ester Edelman
Clinical Social Work/Therapist, LCSW
Verified Verified
Newfield, NY 14867
Thank you for visiting my page. I am a licensed clinical social worker. I was also trained in psychodynamic therapy in Brighton, UK, and I love integrating this modality in my work. I have 19 years of extensive experience working in the community and in college counseling with people who struggle with a wide range of difficulties, including mental health, stress, loneliness, grief, isolation, irritability, relationships, trauma and PTSD, childhood adversities, family entanglements, racial and cultural concerns, unhealthy boundaries, life transitions and decisions making, sleep difficulties, eating and body image and low self esteem.
Thank you for visiting my page. I am a licensed clinical social worker. I was also trained in psychodynamic therapy in Brighton, UK, and I love integrating this modality in my work. I have 19 years of extensive experience working in the community and in college counseling with people who struggle with a wide range of difficulties, including mental health, stress, loneliness, grief, isolation, irritability, relationships, trauma and PTSD, childhood adversities, family entanglements, racial and cultural concerns, unhealthy boundaries, life transitions and decisions making, sleep difficulties, eating and body image and low self esteem.
(607) 603-7110 View (607) 603-7110
Photo of Mike Ellis, Clinical Social Work/Therapist in Spencer, NY
Mike Ellis
Clinical Social Work/Therapist, LCSW
Verified Verified
Ithaca, NY 14850
I have just launched my practice and am eager to welcome new clients! I have appointments available on Tues, Wed, and Thurs at morning, afternoon, and early evening times. I work with adults 18 years old and older. I place a high value on working responsively and effectively with people whose social identities (such as culture and gender) are different than mine. I am a good match for you if you are looking for a warm, non-judgmental therapist to join you on the courageous path of self-discovery and healing. I am especially skilled at helping with issues related to trauma, anxiety, depression, adult ADHD, and relationship conflicts.
I have just launched my practice and am eager to welcome new clients! I have appointments available on Tues, Wed, and Thurs at morning, afternoon, and early evening times. I work with adults 18 years old and older. I place a high value on working responsively and effectively with people whose social identities (such as culture and gender) are different than mine. I am a good match for you if you are looking for a warm, non-judgmental therapist to join you on the courageous path of self-discovery and healing. I am especially skilled at helping with issues related to trauma, anxiety, depression, adult ADHD, and relationship conflicts.
(607) 360-6053 View (607) 360-6053
Photo of Ellen Zaslaw, Psychologist in Spencer, NY
Ellen Zaslaw
Psychologist, PhD
Verified Verified
Newfield, NY 14867  (Online Only)
Treatment is tailored to the needs and preferences of the client. Some situations call for deep introspection, others for charting one's way through a predicament, and still others for behavioral or other targeted techniques. I have tools for all of these.
Treatment is tailored to the needs and preferences of the client. Some situations call for deep introspection, others for charting one's way through a predicament, and still others for behavioral or other targeted techniques. I have tools for all of these.
(607) 269-4174 View (607) 269-4174

Online Therapists

Photo of Dorothy Weishaar, Counselor in Spencer, NY
Dorothy Weishaar
Counselor, LMHC, NCC, ACS, CFLE
Verified Verified
Victor, NY 14564  (Online Only)
My ideal client is an individual who either has been contemplating change or is ready to make changes in their life and would like to have someone objective to talk with. I am open minded and love to learn from my clients. I think that continuing education is vital and that mental health is as important as physical health. My ideal client would be someone who would take what they think is beneficial from our session and practice it in their everyday life. Then we would discuss in future sessions how the practice went and what needs to be adjusted-if anything!
My ideal client is an individual who either has been contemplating change or is ready to make changes in their life and would like to have someone objective to talk with. I am open minded and love to learn from my clients. I think that continuing education is vital and that mental health is as important as physical health. My ideal client would be someone who would take what they think is beneficial from our session and practice it in their everyday life. Then we would discuss in future sessions how the practice went and what needs to be adjusted-if anything!
(585) 522-1137 View (585) 522-1137
Photo of Stephanie Zuber, Counselor in Spencer, NY
Stephanie Zuber
Counselor, LMHC, MS
Verified Verified
Ithaca, NY 14850
I am currently not accepting new patients until 2024. Experiencing a loss of sexual desire? Arguing about frequency of sex? Worried about performance issues? Healing from sexual trauma or infidelity? Want to better understand your sexuality? I specialize in working with individuals, couples and multi-partnered relationships as they explore concerns related to sex, intimacy and gender identity. Using a combination of proven methods in sex therapy and relationship/family therapies, I help people heal and experience a satisfying sex life so they can live a more connected and thriving life.
I am currently not accepting new patients until 2024. Experiencing a loss of sexual desire? Arguing about frequency of sex? Worried about performance issues? Healing from sexual trauma or infidelity? Want to better understand your sexuality? I specialize in working with individuals, couples and multi-partnered relationships as they explore concerns related to sex, intimacy and gender identity. Using a combination of proven methods in sex therapy and relationship/family therapies, I help people heal and experience a satisfying sex life so they can live a more connected and thriving life.
(607) 228-8157 View (607) 228-8157
Photo of Kathleen B Pullano, Clinical Social Work/Therapist in Spencer, NY
Kathleen B Pullano
Clinical Social Work/Therapist, MSW, LCSW-R
Verified Verified
Geneva, NY 14456
As a clinician in the mental health field for over 20 years, I have a great deal of knowledge and experience to offer my clients. I enjoy working with individuals ages 14 and older with a variety of life issues, mental health diagnoses and life stressors. Specifically I utilize empirically based treatment modalities along with a relationship based approach to alleviate pain and suffering caused by mental illness, daily stress, trauma, family conflict, and transitional life changes. I would be honored to assist you on your journey to wellness and self discovery.
As a clinician in the mental health field for over 20 years, I have a great deal of knowledge and experience to offer my clients. I enjoy working with individuals ages 14 and older with a variety of life issues, mental health diagnoses and life stressors. Specifically I utilize empirically based treatment modalities along with a relationship based approach to alleviate pain and suffering caused by mental illness, daily stress, trauma, family conflict, and transitional life changes. I would be honored to assist you on your journey to wellness and self discovery.
(315) 514-3598 View (315) 514-3598
Photo of James A Brace, Clinical Social Work/Therapist in Spencer, NY
James A Brace
Clinical Social Work/Therapist, LCSW-R, MSW, CEET, EMM
Verified Verified
Narrowsburg, NY 12764
My goal is to listen and help you tackle difficult issues, inform and support you so you can feel empowered, every day. Empathy, constructive listening and feedback are combined with theory to provide established clinical support. Concerns such as anxiety or depression, relationship barriers and sexual concerns, career and money difficulties are all welcome. I want to help you find success and feel good about yourself and all that you invest in.
My goal is to listen and help you tackle difficult issues, inform and support you so you can feel empowered, every day. Empathy, constructive listening and feedback are combined with theory to provide established clinical support. Concerns such as anxiety or depression, relationship barriers and sexual concerns, career and money difficulties are all welcome. I want to help you find success and feel good about yourself and all that you invest in.
(917) 725-5251 View (917) 725-5251
Photo of Dr. Lauren Wadsworth, Psychologist in Spencer, NY
Dr. Lauren Wadsworth
Psychologist, PhD, ABPP
Verified Verified
2 Endorsed
Rochester, NY 14623
My passion is treating severe OCD and anxiety. My clients joke that I am "not a talk therapist, but a 'do' therapist," as sessions are often very active and skills focused. I view therapy as a supportive environment where I can help clients face their fears. I only provide evidence-based treatments (methods proven by research to be more effective than general talk therapy), as my goal is to help people get results as soon as possible.
My passion is treating severe OCD and anxiety. My clients joke that I am "not a talk therapist, but a 'do' therapist," as sessions are often very active and skills focused. I view therapy as a supportive environment where I can help clients face their fears. I only provide evidence-based treatments (methods proven by research to be more effective than general talk therapy), as my goal is to help people get results as soon as possible.
(585) 542-1834 View (585) 542-1834
Photo of Matt Spottek, Counselor in Spencer, NY
Matt Spottek
Counselor, MA, LMHC, NCC
Verified Verified
2 Endorsed
Binghamton, NY 13905
Are you feeling overwhelmed or stressed? Are you experiencing anxiety, depression, anger/irritability, mood swings, or just feeling "off?" I am glad that you are reaching out for help. My name is Matt Spottek, and I am a New York State Licensed Mental Health Counselor. I specialize in treating the following issues: Anxiety, depression, stress, addiction, communication issues, symptom management, improving interpersonal awareness, and relationship problems. I can help you identify and address your problems, and together we can develop a plan geared toward wellness and recovery.
Are you feeling overwhelmed or stressed? Are you experiencing anxiety, depression, anger/irritability, mood swings, or just feeling "off?" I am glad that you are reaching out for help. My name is Matt Spottek, and I am a New York State Licensed Mental Health Counselor. I specialize in treating the following issues: Anxiety, depression, stress, addiction, communication issues, symptom management, improving interpersonal awareness, and relationship problems. I can help you identify and address your problems, and together we can develop a plan geared toward wellness and recovery.
(607) 214-2859 View (607) 214-2859
Photo of Karen A Talcott, Clinical Social Work/Therapist in Spencer, NY
Karen A Talcott
Clinical Social Work/Therapist, LCSW-R
Verified Verified
Richford, NY 13835  (Online Only)
In our busy world, it is easy to find ourselves caught in a struggle with a limited understanding of where the struggle comes from or why it even exists. It can feel overwhelming just trying to meet the outer demands of life, let alone understanding the more inward struggle. I see therapy as a space; a needed, safe space to slow life down for even a fraction of a day to focus on the struggle and its solutions. My approach to therapy is inward-searching, awakening inner knowledge and insight to find solutions. For me, this work is sacred, as we are on a journey to understand and find our true selves.
In our busy world, it is easy to find ourselves caught in a struggle with a limited understanding of where the struggle comes from or why it even exists. It can feel overwhelming just trying to meet the outer demands of life, let alone understanding the more inward struggle. I see therapy as a space; a needed, safe space to slow life down for even a fraction of a day to focus on the struggle and its solutions. My approach to therapy is inward-searching, awakening inner knowledge and insight to find solutions. For me, this work is sacred, as we are on a journey to understand and find our true selves.
(607) 300-5362 View (607) 300-5362
Photo of Cemre Korman, Clinical Social Work/Therapist in Spencer, NY
Cemre Korman
Clinical Social Work/Therapist, LCSW
Verified Verified
Rochester, NY 14610  (Online Only)
My name is Cemre (pronounced "gem-ray"). My pronouns are she/her/hers. Therapy for me is a non-judgmental exploration, a collaborative effort between the client(s) and therapist. I provide strength-based and trauma-informed care to individuals, couples, and group therapy/workshops.
My name is Cemre (pronounced "gem-ray"). My pronouns are she/her/hers. Therapy for me is a non-judgmental exploration, a collaborative effort between the client(s) and therapist. I provide strength-based and trauma-informed care to individuals, couples, and group therapy/workshops.
(585) 634-3189 View (585) 634-3189
Photo of Christine M Carroll, Counselor in Spencer, NY
Christine M Carroll
Counselor, LMHC
Verified Verified
Romulus, NY 14541
I recognize the need for innovative and unconventional treatment options. I offer unique services tailored to every individual’s specific needs. I have a backyard office at my place, Bender's Barn Animal Sanctuary & Therapeutic Farm, 501c3. Whether or not you seek to engage in animal integrated services, most people benefit from this relaxing and welcoming environment. I utilize EMDR, IFS, Animal Integrated, TF/CBT, Strength Based, Attachment Theory, Somatic, & Meditative based therapies. I believe in the importance of normalizing therapy & fostering a genuine human connection. Feeling comfortable, related-to, and empowered.
I recognize the need for innovative and unconventional treatment options. I offer unique services tailored to every individual’s specific needs. I have a backyard office at my place, Bender's Barn Animal Sanctuary & Therapeutic Farm, 501c3. Whether or not you seek to engage in animal integrated services, most people benefit from this relaxing and welcoming environment. I utilize EMDR, IFS, Animal Integrated, TF/CBT, Strength Based, Attachment Theory, Somatic, & Meditative based therapies. I believe in the importance of normalizing therapy & fostering a genuine human connection. Feeling comfortable, related-to, and empowered.
(315) 302-1474 View (315) 302-1474
Photo of Kelly M Hint, Counselor in Spencer, NY
Kelly M Hint
Counselor, LMHC, NCC, CCMHC, CCATP
Verified Verified
2 Endorsed
Piffard, NY 14533  (Online Only)
Life is a journey filled with moments of beauty but also with trials and tribulations that we must navigate. At times, walking through the challenges alone can leave us with fear, sadness, doubt, and insurmountable anxiety that others cannot seem to understand. I would be honored to walk beside you in your journey and offer assistance in dealing with some of the obstacles in your path. My compassion and empathy drive me to work hard for you while at the same time challenging you to consider new ideas and ways to approach issues in your life.
Life is a journey filled with moments of beauty but also with trials and tribulations that we must navigate. At times, walking through the challenges alone can leave us with fear, sadness, doubt, and insurmountable anxiety that others cannot seem to understand. I would be honored to walk beside you in your journey and offer assistance in dealing with some of the obstacles in your path. My compassion and empathy drive me to work hard for you while at the same time challenging you to consider new ideas and ways to approach issues in your life.
(585) 302-4083 View (585) 302-4083

See more therapy options for Spencer

How does your Therapist compare?

Number of Therapists in Spencer, NY

< 10

Therapists in Spencer, NY who prioritize treating:

100% Relationship Issues
100% Grief
100% Parenting
100% Trauma and PTSD
100% Anger Management
100% Behavioral Issues
100% Suicidal Ideation

Average years in practice

17 Years

Top 3 insurances accepted

100% Aetna
100% Cigna and Evernorth
100% UnitedHealthcare UHC | UBH

How Therapists in Spencer, NY see their clients

66% Online Only
34% In Person and Online

Gender breakdown

66% Male
34% Female
FAQs - About Therapy and Counseling

How can I find a therapist in Spencer?

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.