Therapists in Garden City, NY

Paul Ruchames
Clinical Social Work/Therapist, LCSW
Verified Verified
Garden City, NY 11530
I have had much success helping adults, couples and families with problems related to anxiety, depression, drug and alcohol abuse and addiction and trauma.
I have had much success helping adults, couples and families with problems related to anxiety, depression, drug and alcohol abuse and addiction and trauma.
(855) 826-9523 View (855) 826-9523
Photo of Raina Harris, Counselor in Garden City, NY
Raina Harris
Counselor
Verified Verified
Garden City, NY 11530
Raina Harris is a Licensed Mental Health Counselor in New York who has been practicing since 2019. She has a Master's Degree in Mental Health Counseling. Raina believes in a treatment philosophy that incorporates psychodynamic, CBT, DBT, and MI. In her spare time, Raina enjoys Zumba, music, her dog, family, and friends. Raina helps her clients find healthy ways to cope with life difficulties in a safe space where they can freely expose their authentic self. She helps her clients explore their strengths and ways to apply them to their current situations.
Raina Harris is a Licensed Mental Health Counselor in New York who has been practicing since 2019. She has a Master's Degree in Mental Health Counseling. Raina believes in a treatment philosophy that incorporates psychodynamic, CBT, DBT, and MI. In her spare time, Raina enjoys Zumba, music, her dog, family, and friends. Raina helps her clients find healthy ways to cope with life difficulties in a safe space where they can freely expose their authentic self. She helps her clients explore their strengths and ways to apply them to their current situations.
(516) 844-0217 View (516) 844-0217
Photo of Erica James, Marriage & Family Therapist in Garden City, NY
Erica James
Marriage & Family Therapist, MS, LMFT
Verified Verified
Garden City, NY 11530
Has your relationship lost that “spark” that it once had? Do you and your partner find yourselves in the same cycle of fighting over seemingly meaningless things? Do you find yourself constantly on edge over things your partner says or does? Does it feel like there isn’t any romance, intimacy, or sex anymore? Do you feel stuck and hopeless? It can feel like you’re with a different person or someone that you don’t even know anymore. The arguments seem to happen more frequently and feel more intense. This leads to resentment and anger, which only continues the argumentative cycle. Being in this place can feel hopeless and hurtful.
Has your relationship lost that “spark” that it once had? Do you and your partner find yourselves in the same cycle of fighting over seemingly meaningless things? Do you find yourself constantly on edge over things your partner says or does? Does it feel like there isn’t any romance, intimacy, or sex anymore? Do you feel stuck and hopeless? It can feel like you’re with a different person or someone that you don’t even know anymore. The arguments seem to happen more frequently and feel more intense. This leads to resentment and anger, which only continues the argumentative cycle. Being in this place can feel hopeless and hurtful.
(516) 347-2512 View (516) 347-2512
Photo of Nassau Wellness: Couples Therapy, Marriage & Family Therapist in Garden City, NY
Nassau Wellness: Couples Therapy
Marriage & Family Therapist, MA, LMFT
Verified Verified
Garden City, NY 11530
Nassau Wellness offers high-quality individual, couples, and family therapy. We provide caring and compassionate support to help our clients identify and achieve the changes important to them. Our practice focuses on empowering our clients to succeed by working collaboratively and developing long-lasting coping skills.
Nassau Wellness offers high-quality individual, couples, and family therapy. We provide caring and compassionate support to help our clients identify and achieve the changes important to them. Our practice focuses on empowering our clients to succeed by working collaboratively and developing long-lasting coping skills.
(516) 252-3670 View (516) 252-3670
Photo of Lynette Miller-Volel, Clinical Social Work/Therapist in Garden City, NY
Lynette Miller-Volel
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Garden City, NY 11530  (Online Only)
I specialize in empowering high achievers who struggle with anxiety, issues with self-esteem, and perfectionism to find more balance and fulfillment in their lives. As high achievers, we're out here making big moves, chasing dreams and striving for excellence. But sometimes anxiety, self-doubt, and burnout creep in and threaten to derail our progress. We'll dive deep to understand the unique challenges you face as a professional. Together, we'll help you find more balance, reclaim your time, and rediscover joy.
I specialize in empowering high achievers who struggle with anxiety, issues with self-esteem, and perfectionism to find more balance and fulfillment in their lives. As high achievers, we're out here making big moves, chasing dreams and striving for excellence. But sometimes anxiety, self-doubt, and burnout creep in and threaten to derail our progress. We'll dive deep to understand the unique challenges you face as a professional. Together, we'll help you find more balance, reclaim your time, and rediscover joy.
(516) 518-2561 View (516) 518-2561
Photo of Michelle Tucci, Marriage & Family Therapist in Garden City, NY
Michelle Tucci
Marriage & Family Therapist, MA, LMFT
Verified Verified
Garden City, NY 11530  (Online Only)
Are you just existing? Going through the daily motions, but not truly living? Caught in a vicious cycle of negative self-talk, low self-esteem, and self-defeating thoughts and behaviors? It doesn't have to be this way. Allow me to help you free yourself of your internal struggles so you can reveal your true potential, and live a more fulfilled and complete life. Through my compassionate, empathic, and non-judgmental approach, I can help you to uncover your true value and the life you deserve to be living.
Are you just existing? Going through the daily motions, but not truly living? Caught in a vicious cycle of negative self-talk, low self-esteem, and self-defeating thoughts and behaviors? It doesn't have to be this way. Allow me to help you free yourself of your internal struggles so you can reveal your true potential, and live a more fulfilled and complete life. Through my compassionate, empathic, and non-judgmental approach, I can help you to uncover your true value and the life you deserve to be living.
(516) 336-4129 View (516) 336-4129
Photo of Melissa Marconi, Clinical Social Work/Therapist in Garden City, NY
Melissa Marconi
Clinical Social Work/Therapist, LCSW
Verified Verified
3 Endorsed
Garden City, NY 11530  (Online Only)
Welcome, and thank you for considering me as your therapist. I am a licensed clinical social worker who specializes in anxiety, stress management, issues related to chronic and physical illness, and life transitions. When confronting challenges such as chronic illness, disability, and mental health issues you may feel that your world has been turned upside down. Everyday tasks and responsibilities may seem impossible and the feelings of hopelessness, guilt, and anxiety can be overwhelming.
Welcome, and thank you for considering me as your therapist. I am a licensed clinical social worker who specializes in anxiety, stress management, issues related to chronic and physical illness, and life transitions. When confronting challenges such as chronic illness, disability, and mental health issues you may feel that your world has been turned upside down. Everyday tasks and responsibilities may seem impossible and the feelings of hopelessness, guilt, and anxiety can be overwhelming.
(516) 874-4237 x712 View (516) 874-4237 x712
Photo of Christine Weiss, Clinical Social Work/Therapist in Garden City, NY
Christine Weiss
Clinical Social Work/Therapist, LCSW
Verified Verified
Garden City, NY 11530
Chris is an experienced therapist who has treated adults with both mental health and substance abuse issues. Chris believes in creating a trusting relationship through active listening and empathy to provide a nonjudgmental atmosphere. She works with each person to help identify achievable goals to bring about meaningful, visible change. Chris specializes in the treatment of Mood Disorders, specifically Anxiety, Depression and Bipolar Disorders. She has had extensive training and experience with Substance Abuse including Co-Occurring Disorders.
Chris is an experienced therapist who has treated adults with both mental health and substance abuse issues. Chris believes in creating a trusting relationship through active listening and empathy to provide a nonjudgmental atmosphere. She works with each person to help identify achievable goals to bring about meaningful, visible change. Chris specializes in the treatment of Mood Disorders, specifically Anxiety, Depression and Bipolar Disorders. She has had extensive training and experience with Substance Abuse including Co-Occurring Disorders.
(516) 774-2640 View (516) 774-2640
Photo of Meagan Miraldi, Counselor in Garden City, NY
Meagan Miraldi
Counselor, LMHC
Verified Verified
1 Endorsed
Garden City, NY 11530
I am a firm believer that everyone can benefit from therapy. My primary goal is to make each of my client’s therapeutic experiences as comfortable and safe as possible. I have worked with clients of all ages, including children, adolescents, young adults, adults, and seniors. Using a client-centered approach, I work with my clients to develop positive coping skills in order to tackle life’s stressors. I have experience working with clients with a variety of diagnoses, including but not limited to substance use disorders, anxiety, depression, bipolar disorder, and personality disorders.
I am a firm believer that everyone can benefit from therapy. My primary goal is to make each of my client’s therapeutic experiences as comfortable and safe as possible. I have worked with clients of all ages, including children, adolescents, young adults, adults, and seniors. Using a client-centered approach, I work with my clients to develop positive coping skills in order to tackle life’s stressors. I have experience working with clients with a variety of diagnoses, including but not limited to substance use disorders, anxiety, depression, bipolar disorder, and personality disorders.
(516) 280-7285 View (516) 280-7285
Photo of Marc J Shulman, Psychologist in Garden City, NY
Marc J Shulman
Psychologist, PsyD
Verified Verified
1 Endorsed
Garden City, NY 11530
You deserve to be better than fine! I am a Long Island psychologist, providing individual, group, and couples counseling, with offices in Garden City, Rockville Centre, and Roslyn Heights, NY. I believe in getting to know you as a person. I offer evidence based treatments, but I account for the personal factor, because you have your own unique needs. My goal is to create a warm environment, work with you on your challenges, and develop solutions that will help you reach your goals. I focus on what will make your life better, and provide support that helps you see results.
You deserve to be better than fine! I am a Long Island psychologist, providing individual, group, and couples counseling, with offices in Garden City, Rockville Centre, and Roslyn Heights, NY. I believe in getting to know you as a person. I offer evidence based treatments, but I account for the personal factor, because you have your own unique needs. My goal is to create a warm environment, work with you on your challenges, and develop solutions that will help you reach your goals. I focus on what will make your life better, and provide support that helps you see results.
(516) 732-0273 View (516) 732-0273
Photo of Stephanie Kahn, Clinical Social Work/Therapist in Garden City, NY
Stephanie Kahn
Clinical Social Work/Therapist, LCSW, RPT-S
Verified Verified
1 Endorsed
Garden City, NY 11530  (Online Only)
For over 20 years, I have been working with all ages and continue to enjoy helping individuals to improve their quality of life. To best meet the unique needs of my Clients, I individualize my approach via a combination of therapies to help them develop insight and more effective ways to meet life's challenges. I work collaboratively with my Clients, including following their lead, to achieve their goals.
For over 20 years, I have been working with all ages and continue to enjoy helping individuals to improve their quality of life. To best meet the unique needs of my Clients, I individualize my approach via a combination of therapies to help them develop insight and more effective ways to meet life's challenges. I work collaboratively with my Clients, including following their lead, to achieve their goals.
(973) 310-2281 View (973) 310-2281
Photo of Lisa Cohen, Clinical Social Work/Therapist in Garden City, NY
Lisa Cohen
Clinical Social Work/Therapist, LCSW
Verified Verified
Garden City, NY 11530
Are you currently going through challenging situations in your life, and need additional support and guidance to help you manage? I have over 20 years of experience treating adults, children, and teenagers. I provide caring, warm, and supportive treatment in a confidential setting. I help individuals, couples, families, children, and teens to figure out ways to overcome life's challenges. By improving self growth, and reaching their goals, my clients often find enhanced happiness and fulfillment in many areas of their lives. I can offer much needed help for parenting, anxiety, depression, trauma, and relationship issues.
Are you currently going through challenging situations in your life, and need additional support and guidance to help you manage? I have over 20 years of experience treating adults, children, and teenagers. I provide caring, warm, and supportive treatment in a confidential setting. I help individuals, couples, families, children, and teens to figure out ways to overcome life's challenges. By improving self growth, and reaching their goals, my clients often find enhanced happiness and fulfillment in many areas of their lives. I can offer much needed help for parenting, anxiety, depression, trauma, and relationship issues.
(516) 726-1032 View (516) 726-1032
Photo of Jaime Wallace, Psychologist in Garden City, NY
Jaime Wallace
Psychologist, PhD
Verified Verified
Garden City, NY 11530
I believe that we are not meant to be defined our past negative experiences but rather free of them so that we may build a more fulfilling future. I have been trained psychodynamically and do trauma focused therapy. Traumas are often incidents that might appear small on the surface but may impact our ability to be intimate with others. I am a member of the International Society of Studies in Trauma and Dissociation and am abreast with newest treatments and research. I work with sexual abuse survivors and work with firemen, police officers and other first responders through psychodynamic therapy and EMDR. I am an EMDR certified
I believe that we are not meant to be defined our past negative experiences but rather free of them so that we may build a more fulfilling future. I have been trained psychodynamically and do trauma focused therapy. Traumas are often incidents that might appear small on the surface but may impact our ability to be intimate with others. I am a member of the International Society of Studies in Trauma and Dissociation and am abreast with newest treatments and research. I work with sexual abuse survivors and work with firemen, police officers and other first responders through psychodynamic therapy and EMDR. I am an EMDR certified
(516) 714-4428 View (516) 714-4428
Photo of Growth Psychology P.C., Psychologist in Garden City, NY
Growth Psychology P.C.
Psychologist, PhD
Verified Verified
Garden City, NY 11530
Clark R. Goldstein, Ph.D., is the founder of Growth Psychology, P.C. He is a former Clinical Assistant Professor of Child and Adolescent Psychiatry at the NYU School of Medicine at the Child Study Center. He specializes in the evaluation and treatment of anxiety and mood disorders in children, teens, and adults. Previously, Dr. Goldstein served as a clinical psychologist at the Child Mind Institute where he worked with children, adults, and their families working to overcome anxiety, depression, and behavioral issues. His responsibilities also included training and supervision of advanced doctoral students and postdoctoral fellows.
Clark R. Goldstein, Ph.D., is the founder of Growth Psychology, P.C. He is a former Clinical Assistant Professor of Child and Adolescent Psychiatry at the NYU School of Medicine at the Child Study Center. He specializes in the evaluation and treatment of anxiety and mood disorders in children, teens, and adults. Previously, Dr. Goldstein served as a clinical psychologist at the Child Mind Institute where he worked with children, adults, and their families working to overcome anxiety, depression, and behavioral issues. His responsibilities also included training and supervision of advanced doctoral students and postdoctoral fellows.
(516) 272-4708 View (516) 272-4708
Photo of Renee Maggiore, Counselor in Garden City, NY
Renee Maggiore
Counselor, LMHC
Verified Verified
1 Endorsed
Garden City, NY 11530
I became a Licensed Mental Health Counselor with the purpose of helping people as they navigate through life’s many ups and downs. I am passionate about helping clients increase their self-awareness and recognize their inner strengths. I aim to provide a non-judgmental, safe space for clients to feel supported and validated. I utilize a client-centered approach to therapy, tailored to suit the needs of my client. I use an eclectic therapeutic approach including EMDR, Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, Motivational Interviewing, and Strength-Based Therapy.
I became a Licensed Mental Health Counselor with the purpose of helping people as they navigate through life’s many ups and downs. I am passionate about helping clients increase their self-awareness and recognize their inner strengths. I aim to provide a non-judgmental, safe space for clients to feel supported and validated. I utilize a client-centered approach to therapy, tailored to suit the needs of my client. I use an eclectic therapeutic approach including EMDR, Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, Motivational Interviewing, and Strength-Based Therapy.
(516) 260-4839 View (516) 260-4839
Photo of Erin Jefferson, Counselor in Garden City, NY
Erin Jefferson
Counselor, LMHC
Verified Verified
Garden City, NY 11530
Erin Jefferson is a Licensed Mental Health Counselor in New York who has been practicing since 2020. Erin has a knack for helping people of all ages navigate life's twists and turns. Whether you're feeling overwhelmed, stuck in a rut, or just need someone to talk to, Erin is here to lend an ear and offer practical solutions that work for you. With Erin, therapy isn't just about sitting in a stuffy office and spilling your guts "“ it's about creating a safe, supportive space where you can explore your thoughts and feelings, learn new coping strategies, and have a few laughs along the way.
Erin Jefferson is a Licensed Mental Health Counselor in New York who has been practicing since 2020. Erin has a knack for helping people of all ages navigate life's twists and turns. Whether you're feeling overwhelmed, stuck in a rut, or just need someone to talk to, Erin is here to lend an ear and offer practical solutions that work for you. With Erin, therapy isn't just about sitting in a stuffy office and spilling your guts "“ it's about creating a safe, supportive space where you can explore your thoughts and feelings, learn new coping strategies, and have a few laughs along the way.
(516) 715-5449 View (516) 715-5449
Photo of Amanda Marcus, LCSW, Clinical Social Work/Therapist in Garden City, NY
Amanda Marcus, LCSW
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Garden City, NY 11530
Therapy is an exciting time of growth, self-realization and change. I can help you on your journey of healing, self-exploration and self-actualization. I completed my master's degree from NYU and have post-graduate training and extensive clinical experience working with eating disorders but work with a wide variety of mental health concerns. I am a former clinical director of a residential eating disorder facility and I will collaborate with your treatment team if you are seeking eating disorder treatment. I offer a free phone consultation to see how I can help you reach your personal goals.
Therapy is an exciting time of growth, self-realization and change. I can help you on your journey of healing, self-exploration and self-actualization. I completed my master's degree from NYU and have post-graduate training and extensive clinical experience working with eating disorders but work with a wide variety of mental health concerns. I am a former clinical director of a residential eating disorder facility and I will collaborate with your treatment team if you are seeking eating disorder treatment. I offer a free phone consultation to see how I can help you reach your personal goals.
(516) 265-7044 View (516) 265-7044
Photo of Raising Hope Mental Health Counseling, Counselor in Garden City, NY
Raising Hope Mental Health Counseling
Counselor, MA, LMHC
Verified Verified
4 Endorsed
Garden City, NY 11530
I have substantial experience in the treatment of addictive disorders, trauma and dual diagnosis with both adolescents and adults. I've been able to assist many people obtain and sustain their recovery so they can establish a healthy lifestyle, improve their relationships and effectively manage life on life's terms. By taking a person-centered approach, I can meet you where you are in your life and help you implement a plan to achieve your recovery emotionally, mentally and physically.
I have substantial experience in the treatment of addictive disorders, trauma and dual diagnosis with both adolescents and adults. I've been able to assist many people obtain and sustain their recovery so they can establish a healthy lifestyle, improve their relationships and effectively manage life on life's terms. By taking a person-centered approach, I can meet you where you are in your life and help you implement a plan to achieve your recovery emotionally, mentally and physically.
(516) 217-8603 View (516) 217-8603
Photo of Briana Tartaglione, Pre-Licensed Professional in Garden City, NY
Briana Tartaglione
Pre-Licensed Professional, EdM
Verified Verified
3 Endorsed
Garden City, NY 11530
Therapy is a place where we learn to cope with our feelings. As humans, we find hope in healing. Healing welcomes an ongoing balance between strength and struggle. My integrative approach to creating a safe space encourages clients to explore, gather, design, untangle, and make-meaning of the beliefs and conditions that detail our existence.
Therapy is a place where we learn to cope with our feelings. As humans, we find hope in healing. Healing welcomes an ongoing balance between strength and struggle. My integrative approach to creating a safe space encourages clients to explore, gather, design, untangle, and make-meaning of the beliefs and conditions that detail our existence.
(516) 882-3310 View (516) 882-3310
Photo of Rebecca M Brown, Marriage & Family Therapist in Garden City, NY
Rebecca M Brown
Marriage & Family Therapist, LMFT
Verified Verified
Garden City, NY 11530  (Online Only)
I work with clients to help identify, process and heal relational issues whether it be familial, romantic, professional, or platonic. I also work with clients suffering from and feeling held back by the scars of trauma, emotional wounds, and maladaptive behavior patterns. I help clients to acknowledge their pain and/or the role they play in their dissatisfaction, slowly process it, accept it, and implement new paths forward so they can take back control of their lives and enjoy closer relationships.
I work with clients to help identify, process and heal relational issues whether it be familial, romantic, professional, or platonic. I also work with clients suffering from and feeling held back by the scars of trauma, emotional wounds, and maladaptive behavior patterns. I help clients to acknowledge their pain and/or the role they play in their dissatisfaction, slowly process it, accept it, and implement new paths forward so they can take back control of their lives and enjoy closer relationships.
(646) 916-5333 View (646) 916-5333

How does your Therapist compare?

Number of Therapists in Garden City, NY

300+

Average cost per session

$175

Therapists in Garden City, NY who prioritize treating:

95% Anxiety
92% Depression
81% Relationship Issues
78% Self Esteem
72% Coping Skills
67% Trauma and PTSD
65% Stress

Average years in practice

14 Years

Top 3 insurances accepted

79% Aetna
67% Cigna and Evernorth
63% UnitedHealthcare UHC | UBH

How Therapists in Garden City, NY see their clients

74% In Person and Online
26% Online Only

Gender breakdown

85% Female
14% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Garden City?

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.