Therapists in Middletown, CT

Photo of Katie Conforti, Licensed Professional Counselor in Middletown, CT
Katie Conforti
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Middletown, CT 06457
Not accepting new clients
***Not currently accepting new clients*** Self-care and finding balance are so important. I would like to help you feel more at ease, and better able to handle some of life's difficulties. I have worked with a diverse range of individuals seeking support in areas such as depression, anxiety, stress management, grief and loss, relationship issues, infertility, trauma, and addiction.
***Not currently accepting new clients*** Self-care and finding balance are so important. I would like to help you feel more at ease, and better able to handle some of life's difficulties. I have worked with a diverse range of individuals seeking support in areas such as depression, anxiety, stress management, grief and loss, relationship issues, infertility, trauma, and addiction.
(959) 500-6106 View (959) 500-6106
Photo of Myshala Wilson, Licensed Professional Counselor in Middletown, CT
Myshala Wilson
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Middletown, CT 06457  (Online Only)
Hi! I am Myshala Wilson, a Licensed Professional Counselor with a passion for creating a safe place for people to be themselves. Often we are overwhelmed by the changes of life and need a space where we can be free of expectations, judgment, responsibilities, and oppressions. My focus is supporting people through different phases of their life and helping them grow. Every person wants to be heard and feel like their experiences matter. My goal is to work with my clients as a team and help them feel encouraged to make change and be empowered in their decisions.
Hi! I am Myshala Wilson, a Licensed Professional Counselor with a passion for creating a safe place for people to be themselves. Often we are overwhelmed by the changes of life and need a space where we can be free of expectations, judgment, responsibilities, and oppressions. My focus is supporting people through different phases of their life and helping them grow. Every person wants to be heard and feel like their experiences matter. My goal is to work with my clients as a team and help them feel encouraged to make change and be empowered in their decisions.
(860) 791-3226 View (860) 791-3226
Photo of Winifred M Neville, Licensed Professional Counselor in Middletown, CT
Winifred M Neville
Licensed Professional Counselor, LPC
Verified Verified
Middletown, CT 06457
Waitlist for new clients
I have been working in the field of Mental Health and Addiction for 20 years. I graduated with a Master's degree in Mental Health Counseling from CCSU. My main focus is trauma, centering on Addictions, including substance abuse, eating disorders and excessive spending, however, I am also experienced working with clients who have, depression, anxiety or trauma related symptoms. I have extensive experience working with adolescents and adults I believe strongly in recovery, use various therapeutic approaches to assist clients to live a productive and self directed life. And pets are always welcome so bring yours in.
I have been working in the field of Mental Health and Addiction for 20 years. I graduated with a Master's degree in Mental Health Counseling from CCSU. My main focus is trauma, centering on Addictions, including substance abuse, eating disorders and excessive spending, however, I am also experienced working with clients who have, depression, anxiety or trauma related symptoms. I have extensive experience working with adolescents and adults I believe strongly in recovery, use various therapeutic approaches to assist clients to live a productive and self directed life. And pets are always welcome so bring yours in.
(860) 406-5906 x1 View (860) 406-5906 x1
Photo of Small Victories Wellness Services, Psychologist in Middletown, CT
Small Victories Wellness Services
Psychologist
Verified Verified
1 Endorsed
Middletown, CT 06457
At Small Victories Wellness Services, we are a team of highly skilled therapists that provide in-person talk therapy (Middletown) and telehealth services to adults, children, and families throughout Connecticut & Missouri. We believe that you deserve more than to be just barely getting by. You’ve been struggling to figure it out on your own for far too long. Whatever the issue, our staff will meet you or your family right where you are. You don’t have to walk through the door with answers. We can figure it out together. We understand that change is a journey, and we can take it one small victory at a time.
At Small Victories Wellness Services, we are a team of highly skilled therapists that provide in-person talk therapy (Middletown) and telehealth services to adults, children, and families throughout Connecticut & Missouri. We believe that you deserve more than to be just barely getting by. You’ve been struggling to figure it out on your own for far too long. Whatever the issue, our staff will meet you or your family right where you are. You don’t have to walk through the door with answers. We can figure it out together. We understand that change is a journey, and we can take it one small victory at a time.
(860) 854-8085 View (860) 854-8085
Photo of Haleigh Lombardi, Clinical Social Work/Therapist in Middletown, CT
Haleigh Lombardi
Clinical Social Work/Therapist, LCSW
Verified Verified
Middletown, CT 06457  (Online Only)
Waitlist for new clients
Welcome! I know how hard it is reaching out for help and I commend you for even looking! I am here for you in your time of need. I specialize in anxiety, mood disorders, family conflicts, and many more issues. I am a licensed clinical social worker with experience ranging from crisis intervention, hospital social work, school social work, and community care.
Welcome! I know how hard it is reaching out for help and I commend you for even looking! I am here for you in your time of need. I specialize in anxiety, mood disorders, family conflicts, and many more issues. I am a licensed clinical social worker with experience ranging from crisis intervention, hospital social work, school social work, and community care.
(860) 847-8927 View (860) 847-8927
Photo of Sarah Thibodeau, Clinical Social Work/Therapist in Middletown, CT
Sarah Thibodeau
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Middletown, CT 06457
In this fast-paced and overstimulating world, it's easy to lose sight of our own needs. The demands of everyday life can be incredibly overwhelming and may have gotten in the way of your intentions to take good care of yourself. Reaching out for support when you are distressed is a big step and I am so glad you’re here. My goal is to create a warm, empathetic, and judgment-free space where you can receive support to live a full, manageable life. I support individuals stuggling with anxiety and looking to make changes in their lives and relationships, those going through life transitions, and individuals in all stages of parenting.
In this fast-paced and overstimulating world, it's easy to lose sight of our own needs. The demands of everyday life can be incredibly overwhelming and may have gotten in the way of your intentions to take good care of yourself. Reaching out for support when you are distressed is a big step and I am so glad you’re here. My goal is to create a warm, empathetic, and judgment-free space where you can receive support to live a full, manageable life. I support individuals stuggling with anxiety and looking to make changes in their lives and relationships, those going through life transitions, and individuals in all stages of parenting.
(860) 854-8095 View (860) 854-8095
Photo of Kenia E Egozcue, Licensed Professional Counselor in Middletown, CT
Kenia E Egozcue
Licensed Professional Counselor, MS, LPC
Verified Verified
Middletown, CT 06457  (Online Only)
Starting therapy is a challenging decision as we typically feel that we should manage things on our own. However, you realize that your symptoms are worsening. It may be getting to the point that it's interfering with your performance at school/work. You are having more difficulties getting out of bed and/or you may be overwhelmed by everything going on. You start realizing that now you are avoiding things you used to do because it gives you temporary relief from your anxiety. I would like to help you explore the underlying causes and provide you with tools to enjoy the things that are important to you.
Starting therapy is a challenging decision as we typically feel that we should manage things on our own. However, you realize that your symptoms are worsening. It may be getting to the point that it's interfering with your performance at school/work. You are having more difficulties getting out of bed and/or you may be overwhelmed by everything going on. You start realizing that now you are avoiding things you used to do because it gives you temporary relief from your anxiety. I would like to help you explore the underlying causes and provide you with tools to enjoy the things that are important to you.
(860) 499-4874 View (860) 499-4874
Photo of Sam Mashaw, Pre-Licensed Professional in Middletown, CT
Sam Mashaw
Pre-Licensed Professional, LMSW
Verified Verified
1 Endorsed
Middletown, CT 06457  (Online Only)
I’m Sam Mashaw, a clinical social worker committed to helping you cultivate the self-confidence and self-compassion to step into your wholeness. We live in a society that often seems designed to keep us small, keep us scared, and keep us doubting ourselves. I consider how social context–historical, present, personal, and systemic–may be influencing the stories you have about yourself, your relationships, and the possibilities for your life. The truth is this: the world needs YOU, your unique gifts, and perspective. Whatever you’re going through, I am here to help you tap into your innate strengths and wisdom to navigate your life.
I’m Sam Mashaw, a clinical social worker committed to helping you cultivate the self-confidence and self-compassion to step into your wholeness. We live in a society that often seems designed to keep us small, keep us scared, and keep us doubting ourselves. I consider how social context–historical, present, personal, and systemic–may be influencing the stories you have about yourself, your relationships, and the possibilities for your life. The truth is this: the world needs YOU, your unique gifts, and perspective. Whatever you’re going through, I am here to help you tap into your innate strengths and wisdom to navigate your life.
(860) 390-5194 View (860) 390-5194
Photo of Susan M Hameline-Kasznay, Marriage & Family Therapist in Middletown, CT
Susan M Hameline-Kasznay
Marriage & Family Therapist, LMFT
Verified Verified
Middletown, CT 06457
I have been treating families, couples, individuals and children for over 20 years. I enjoy working with families in transition, including divorce and blended families. I have experience in treating people with depression and anxiety as well.
I have been treating families, couples, individuals and children for over 20 years. I enjoy working with families in transition, including divorce and blended families. I have experience in treating people with depression and anxiety as well.
(860) 455-4697 View (860) 455-4697
Photo of Darlene Shuff Porter, Drug & Alcohol Counselor in Middletown, CT
Darlene Shuff Porter
Drug & Alcohol Counselor, MS, LADC, MAC
Verified Verified
Middletown, CT 06457
If you are struggling with a substance abuse problem and experiencing difficulty in making the decision to stop using drugs/alcohol, well struggle no more. Today can be the beginning of a new life for you without the use of any mind-altering substances. I will work with you in a safe, confidential and supportive environment to bring about change and establish goals that you believe are achievable by meeting you where you are in your individual journey towards recovery and wellness.
If you are struggling with a substance abuse problem and experiencing difficulty in making the decision to stop using drugs/alcohol, well struggle no more. Today can be the beginning of a new life for you without the use of any mind-altering substances. I will work with you in a safe, confidential and supportive environment to bring about change and establish goals that you believe are achievable by meeting you where you are in your individual journey towards recovery and wellness.
(860) 756-5265 View (860) 756-5265
Photo of Rachael Pelletti, Licensed Professional Counselor in Middletown, CT
Rachael Pelletti
Licensed Professional Counselor, LPC, CRC
Verified Verified
Middletown, CT 06457  (Online Only)
I’m Rachael, a Licensed Professional Counselor and Certified Rehabilitation Counselor. You’ve likely known for awhile that you’re needing some additional support. Sometimes it can take awhile to feel ready to take this first step. I want you to know that I’m here to match your pace and honor your unique needs and goals throughout treatment. You can reach out today without fully knowing what you need or how to begin. We can figure it out together as we go. I specialize in addiction recovery and substance use disorders. I also love working with college students that are navigating various life transitions and relationships.
I’m Rachael, a Licensed Professional Counselor and Certified Rehabilitation Counselor. You’ve likely known for awhile that you’re needing some additional support. Sometimes it can take awhile to feel ready to take this first step. I want you to know that I’m here to match your pace and honor your unique needs and goals throughout treatment. You can reach out today without fully knowing what you need or how to begin. We can figure it out together as we go. I specialize in addiction recovery and substance use disorders. I also love working with college students that are navigating various life transitions and relationships.
(860) 485-7353 View (860) 485-7353
Photo of Allissa Tamiso, Licensed Professional Counselor in Middletown, CT
Allissa Tamiso
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Middletown, CT 06457
I’m Allissa Tamiso, a Licensed Professional Counselor with a Master’s degree in Counseling from Central Connecticut State University. I know that you’re just trying to be happy, and it feels like happiness is harder than it should be. You see other people who seem to understand how to navigate life seamlessly, while you feel like you don’t quite get it, or that there are endless obstacles in your way. This is where our work begins. I have worked with folks struggling with anxiety, depression, grief and loss, PTSD, ADHD, relationship issues and life transitions.
I’m Allissa Tamiso, a Licensed Professional Counselor with a Master’s degree in Counseling from Central Connecticut State University. I know that you’re just trying to be happy, and it feels like happiness is harder than it should be. You see other people who seem to understand how to navigate life seamlessly, while you feel like you don’t quite get it, or that there are endless obstacles in your way. This is where our work begins. I have worked with folks struggling with anxiety, depression, grief and loss, PTSD, ADHD, relationship issues and life transitions.
(860) 831-3347 View (860) 831-3347
Photo of Ashley Hines Lunt, Licensed Professional Counselor in Middletown, CT
Ashley Hines Lunt
Licensed Professional Counselor, ATR-BC, LPC
Verified Verified
1 Endorsed
Middletown, CT 06457
Sometimes the difficult times in life impact us in ways that go beyond words. Upheaval, loss, stressful events, or transitions we did not expect. Are you looking for a fresh approach to counseling? Have you felt stuck in moving forward in traditional talk therapy? Children, teens, and adults alike find Art Therapy an approachable and meaningful type of counseling. Visual expression gives voice to your experiences in new and healing ways.
Sometimes the difficult times in life impact us in ways that go beyond words. Upheaval, loss, stressful events, or transitions we did not expect. Are you looking for a fresh approach to counseling? Have you felt stuck in moving forward in traditional talk therapy? Children, teens, and adults alike find Art Therapy an approachable and meaningful type of counseling. Visual expression gives voice to your experiences in new and healing ways.
(475) 900-3113 View (475) 900-3113
Photo of Fabiana Silva, Clinical Social Work/Therapist in Middletown, CT
Fabiana Silva
Clinical Social Work/Therapist, LCSW
Verified Verified
2 Endorsed
Middletown, CT 06457
With nearly a decade of experience in the field of psychotherapy, I am Fabiana Silva, a passionate and dedicated professional specializing in healing trauma. My extensive expertise spans across various therapeutic modalities, enabling me to provide comprehensive and personalized care to my clients. As a multilingual therapist fluent in English, Portuguese, and Spanish, I am the founder of Sunrise Mental Health Services, dedicated to offering compassionate and culturally sensitive mental health support.
With nearly a decade of experience in the field of psychotherapy, I am Fabiana Silva, a passionate and dedicated professional specializing in healing trauma. My extensive expertise spans across various therapeutic modalities, enabling me to provide comprehensive and personalized care to my clients. As a multilingual therapist fluent in English, Portuguese, and Spanish, I am the founder of Sunrise Mental Health Services, dedicated to offering compassionate and culturally sensitive mental health support.
(860) 846-3728 View (860) 846-3728
Photo of Christine O'Grady, Clinical Social Work/Therapist in Middletown, CT
Christine O'Grady
Clinical Social Work/Therapist, LCSW
Verified Verified
Middletown, CT 06457
I look forward to working with and helping people of all ages. Individuals and families can expect the use of reflective practice, mindfulness and humor. Many individuals are dealing with stressful situations with life's ever present changes. I offer assistance in goal setting and follow through. For young children and their families I use a Child-Parent Psychotherapeutic approach and can combine this with trauma work. Perinatal families can expect a deep understanding of the stages of becoming a parent and struggling.
I look forward to working with and helping people of all ages. Individuals and families can expect the use of reflective practice, mindfulness and humor. Many individuals are dealing with stressful situations with life's ever present changes. I offer assistance in goal setting and follow through. For young children and their families I use a Child-Parent Psychotherapeutic approach and can combine this with trauma work. Perinatal families can expect a deep understanding of the stages of becoming a parent and struggling.
(860) 852-4634 View (860) 852-4634
Photo of Carly Gottehrer, Licensed Professional Counselor in Middletown, CT
Carly Gottehrer
Licensed Professional Counselor, MA, LPC
Verified Verified
Middletown, CT 06457
Currently Accepting New Clients. The reality of pregnancy and childbirth doesn't always match up to the expectations. Please know you're not alone. Family transitions can contribute to changes in family dynamics and feel overwhelming - no matter your role within the family. It's not always easy to reach out for support, but a phone call is the first step toward getting back on track. I specialize in peripartum mental health.
Currently Accepting New Clients. The reality of pregnancy and childbirth doesn't always match up to the expectations. Please know you're not alone. Family transitions can contribute to changes in family dynamics and feel overwhelming - no matter your role within the family. It's not always easy to reach out for support, but a phone call is the first step toward getting back on track. I specialize in peripartum mental health.
(860) 406-7519 x2 View (860) 406-7519 x2
Photo of Patrick Russolillo, Psychologist in Middletown, CT
Patrick Russolillo
Psychologist, PhD
Verified Verified
Middletown, CT 06457
I am a licensed psychologist. I have been practicing psychology for 40 years and have been in private practice for 30 years. The vast majority of my training during the course of my career has been in the area of behavioral assessment, behavioral interventions and cognitive-behavioral techniques. I take a directive and problem solving approach to counseling. I offer the following services: cognitive and behavior therapy for children, adolescents and adults, psychological evaluations, evaluation of autism, interventions and treatment for anxiety, and depression. Behavioral intervention for sleep and insomnia.
I am a licensed psychologist. I have been practicing psychology for 40 years and have been in private practice for 30 years. The vast majority of my training during the course of my career has been in the area of behavioral assessment, behavioral interventions and cognitive-behavioral techniques. I take a directive and problem solving approach to counseling. I offer the following services: cognitive and behavior therapy for children, adolescents and adults, psychological evaluations, evaluation of autism, interventions and treatment for anxiety, and depression. Behavioral intervention for sleep and insomnia.
(860) 552-6383 View (860) 552-6383
Photo of Maegan Glover, Clinical Social Work/Therapist in Middletown, CT
Maegan Glover
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Middletown, CT 06457
I’m Maegan, a Licensed Clinical Social Worker who specializes in behavioral outbursts and emotion regulation challenges in children (6+). In addition to these specialties, I am also passionate about helping teens and young adults thrive and cope with anxiety, depression, trauma, ADHD, self-harm, relationship issues, and more. When working with me, you can expect a nurturing and safe space where you’ll feel validated and understood. I identify as LGBTQ+ affirming and am personally and professionally committed to racial justice.
I’m Maegan, a Licensed Clinical Social Worker who specializes in behavioral outbursts and emotion regulation challenges in children (6+). In addition to these specialties, I am also passionate about helping teens and young adults thrive and cope with anxiety, depression, trauma, ADHD, self-harm, relationship issues, and more. When working with me, you can expect a nurturing and safe space where you’ll feel validated and understood. I identify as LGBTQ+ affirming and am personally and professionally committed to racial justice.
(860) 579-1318 View (860) 579-1318
Photo of Middletown Counseling Llc, Clinical Social Work/Therapist in Middletown, CT
Middletown Counseling Llc
Clinical Social Work/Therapist
Verified Verified
Middletown, CT 06457
We are currently taking new clients! Hi there! We are a small group practice housing several lovely clinicians with varying specialities. The one thing we all have in common is a passion for working with people to make life better. Please feel free to reach out to see if one of us could be a good fit for you, we look forward to hearing from you! To learn more about us individually, check out our website: https://www.middletowncounselingllc.org/
We are currently taking new clients! Hi there! We are a small group practice housing several lovely clinicians with varying specialities. The one thing we all have in common is a passion for working with people to make life better. Please feel free to reach out to see if one of us could be a good fit for you, we look forward to hearing from you! To learn more about us individually, check out our website: https://www.middletowncounselingllc.org/
(959) 214-4772 View (959) 214-4772
Photo of Lauri Weber, Drug & Alcohol Counselor in Middletown, CT
Lauri Weber
Drug & Alcohol Counselor, LADC, MFT
Verified Verified
4 Endorsed
Middletown, CT 06457
Addiction is one of the most serious epidemics of our time. I specialize in treating individuals and families who are struggling with the pain of loving someone who suffers with the disease of addiction. For every person struggling with addiction, there are family members and friends affected, and they also face many challenges. Addiction, the resulting trauma and interpersonal conflicts can manifest in depression, anxiety and anger. With support, professional guidance and empathy, those grappling with these challenges can find the strength, hope and determination to create change and find new meaning in their lives.
Addiction is one of the most serious epidemics of our time. I specialize in treating individuals and families who are struggling with the pain of loving someone who suffers with the disease of addiction. For every person struggling with addiction, there are family members and friends affected, and they also face many challenges. Addiction, the resulting trauma and interpersonal conflicts can manifest in depression, anxiety and anger. With support, professional guidance and empathy, those grappling with these challenges can find the strength, hope and determination to create change and find new meaning in their lives.
(860) 901-1645 View (860) 901-1645

How does your Therapist compare?

Number of Therapists in Middletown, CT

200+

Average cost per session

$145

Therapists in Middletown, CT who prioritize treating:

93% Anxiety
90% Depression
82% Relationship Issues
78% Self Esteem
74% Trauma and PTSD
71% Coping Skills
66% Life Transitions

Average years in practice

12 Years

Top 3 insurances accepted

75% Cigna and Evernorth
71% Husky | CT BHP
68% Aetna

How Therapists in Middletown, CT see their clients

72% In Person and Online
28% Online Only

Gender breakdown

88% Female
12% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Middletown?

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.