Photo of Reneé Todd, LCSW, Clinical Social Work/Therapist
Reneé Todd
Clinical Social Work/Therapist, LCSW
Verified Verified
Chester Springs, PA 19425  (Online Only)
Sometimes life hands us more than we can deal with on our own; that’s why I became a therapist- to help people manage through difficult times so they can find a sense of safety & security to function at their best. Whether it's due to stress, anxiety, relationship/family challenges, or past emotional pain, we’ll work together to help you discover what you need to heal and grow. As a licensed therapist as well as a clinical supervisor of therapists, over the years, I’ve guided hundreds of individuals, couples, parents, and families in defining and connecting to the ideals, values, and relationships that made them feel whole again.
Sometimes life hands us more than we can deal with on our own; that’s why I became a therapist- to help people manage through difficult times so they can find a sense of safety & security to function at their best. Whether it's due to stress, anxiety, relationship/family challenges, or past emotional pain, we’ll work together to help you discover what you need to heal and grow. As a licensed therapist as well as a clinical supervisor of therapists, over the years, I’ve guided hundreds of individuals, couples, parents, and families in defining and connecting to the ideals, values, and relationships that made them feel whole again.
(610) 215-2037 View (610) 215-2037
Photo of Sharie L. Neal, MA, LPC, LPCMH, EMDR, Licensed Professional Counselor
Sharie L. Neal
Licensed Professional Counselor, MA, LPC, LPCMH, EMDR
Verified Verified
Chester Springs, PA 19425  (Online Only)
As a Christian counselor and EMDR trauma specialist, Sharie partners with clients to bring healing and wholeness through a therapeutic partnership and integrative counseling approach that provide knowledge, practical application, and hope. Her 30 years of counseling experience and training have made her knowledgeable and skilled at uncovering root problems and identifying life processes that lead to recovery. Sharie is an author and consultant partnering with groups as a workshop and conference instructor.
As a Christian counselor and EMDR trauma specialist, Sharie partners with clients to bring healing and wholeness through a therapeutic partnership and integrative counseling approach that provide knowledge, practical application, and hope. Her 30 years of counseling experience and training have made her knowledgeable and skilled at uncovering root problems and identifying life processes that lead to recovery. Sharie is an author and consultant partnering with groups as a workshop and conference instructor.
(610) 345-7991 View (610) 345-7991
Photo of Carol Gaspar, MEd, Psychologist
Carol Gaspar
Psychologist, MEd
Verified Verified
2 Endorsed
"The journey of a thousand miles begins with a single step."Lao-tzu You have just taken the first step of that journey. Life presents us with many challenges along the way. We may experience loss and significant changes in our lives. These challenges may present themselves in the many relationships we have with others, in our jobs, at school, and in our families. These challenges may affect our moods, cause us worry and despair, hamper our spirits, sadden us, confuse us and result in either our stumbling off course or losing a sense of direction. Therapy can be most helpful in getting you back on track and continuing your journey.
"The journey of a thousand miles begins with a single step."Lao-tzu You have just taken the first step of that journey. Life presents us with many challenges along the way. We may experience loss and significant changes in our lives. These challenges may present themselves in the many relationships we have with others, in our jobs, at school, and in our families. These challenges may affect our moods, cause us worry and despair, hamper our spirits, sadden us, confuse us and result in either our stumbling off course or losing a sense of direction. Therapy can be most helpful in getting you back on track and continuing your journey.
(610) 616-5802 View (610) 616-5802
Photo of Toni Gorn, LCSW, Clinical Social Work/Therapist
Toni Gorn
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Chester Springs, PA 19425  (Online Only)
You’re looking in the mirror and you know something is missing. You don’t know how you got to this place, but you know you’re unhappy. You snap at your kids for being kids, at your partner for the same things that used to make you laugh. There’s guides for the engagement, the wedding and starting a family. Where’s the app for AFTER? You need someone to take a look from a different perspective, and help you have the hard conversation to find yourself and your relationship again. I can help you set goals individually and as a couple to guide you to a level of self-awareness to manage the obstacles of a relationship and life.
You’re looking in the mirror and you know something is missing. You don’t know how you got to this place, but you know you’re unhappy. You snap at your kids for being kids, at your partner for the same things that used to make you laugh. There’s guides for the engagement, the wedding and starting a family. Where’s the app for AFTER? You need someone to take a look from a different perspective, and help you have the hard conversation to find yourself and your relationship again. I can help you set goals individually and as a couple to guide you to a level of self-awareness to manage the obstacles of a relationship and life.
(813) 544-1388 View (813) 544-1388
Photo of Dr. Bre Ford, PsyD, LMFT, Marriage & Family Therapist
Dr. Bre Ford
Marriage & Family Therapist, PsyD, LMFT
Verified Verified
4 Endorsed
Are you or your child struggling? Does your child display anxiety more often than it seems he or she should? Are they missing out on an enjoyable, if not "typical" grade school or college experience? Or, maybe you are trying to conceive, and having difficulty feeling calm and seeing the outcomes you desire? Wherever you or your loved one is on their journey, I hear you and I see you. Our bodies are wired for stress as a means of protecting us from potential danger, but sometimes we get "stuck" in our stress response, which can keep us from our goals. I help clients challenge these responses to form more healthy, adaptable ones.
Are you or your child struggling? Does your child display anxiety more often than it seems he or she should? Are they missing out on an enjoyable, if not "typical" grade school or college experience? Or, maybe you are trying to conceive, and having difficulty feeling calm and seeing the outcomes you desire? Wherever you or your loved one is on their journey, I hear you and I see you. Our bodies are wired for stress as a means of protecting us from potential danger, but sometimes we get "stuck" in our stress response, which can keep us from our goals. I help clients challenge these responses to form more healthy, adaptable ones.
(619) 274-0810 View (619) 274-0810
Photo of Kerstin Miller, MDiv, LMFT, CST, Marriage & Family Therapist
Kerstin Miller
Marriage & Family Therapist, MDiv, LMFT, CST
Verified Verified
3 Endorsed
I specialize in anger-management, sex-therapy, Emdr, depression, and anxiety. I support men and women to rediscover their self-confidence and help clients to get in touch with a positive sense of self that enhances life quality and performance. In addition I specialize in couples therapy, where I support couples to hear and understand each other in a more empathic way. My focus is to create an emotionally safe environment that allows for sharing, without repetition of destructive patterns in session. I guide couples to feel compassion which leads partners to rediscover love, hope, and optimism for the future.
I specialize in anger-management, sex-therapy, Emdr, depression, and anxiety. I support men and women to rediscover their self-confidence and help clients to get in touch with a positive sense of self that enhances life quality and performance. In addition I specialize in couples therapy, where I support couples to hear and understand each other in a more empathic way. My focus is to create an emotionally safe environment that allows for sharing, without repetition of destructive patterns in session. I guide couples to feel compassion which leads partners to rediscover love, hope, and optimism for the future.
(484) 851-9260 View (484) 851-9260
Photo of Nazie Meacham, MA, LPC, ATR-BC, Licensed Professional Counselor
Nazie Meacham
Licensed Professional Counselor, MA, LPC, ATR-BC
Verified Verified
Not accepting new clients
For over fifteen years, I have been honored to walk beside hundreds of people in their journey to greater empowerment and resiliency. Within the therapeutic relationship, we will work collaboratively to identify obstacles to wellness, develop skills for personal coping, illuminate individual strengths, and nurture individuals' inherent potential to thrive. I provide a non-judgmental and compassionate space to support individuals path of recognizing and attending to personal needs and self acceptance. I love to meet people where they are, bringing in a variety of tools to enhance growth and support each person's individual goals.
For over fifteen years, I have been honored to walk beside hundreds of people in their journey to greater empowerment and resiliency. Within the therapeutic relationship, we will work collaboratively to identify obstacles to wellness, develop skills for personal coping, illuminate individual strengths, and nurture individuals' inherent potential to thrive. I provide a non-judgmental and compassionate space to support individuals path of recognizing and attending to personal needs and self acceptance. I love to meet people where they are, bringing in a variety of tools to enhance growth and support each person's individual goals.
(610) 601-2415 View (610) 601-2415
Photo of Suzanne R Benko, LMFT, Marriage & Family Therapist
Suzanne R Benko
Marriage & Family Therapist, LMFT
Verified Verified
Thanks for taking the time to learn a little bit about me. I have over 30 years experience working with adolescents, adults, couples, and families. I've worked in a variety of settings, including private practice, public schools, colleges, and non-profit organizations. It's so important, in addition to education & credentials, for the therapist you choose to be a good fit for you in personality & style. I would be happy to provide you with a free phone consult to give you a sense of whether I am the therapist best suited to meet your needs.
Thanks for taking the time to learn a little bit about me. I have over 30 years experience working with adolescents, adults, couples, and families. I've worked in a variety of settings, including private practice, public schools, colleges, and non-profit organizations. It's so important, in addition to education & credentials, for the therapist you choose to be a good fit for you in personality & style. I would be happy to provide you with a free phone consult to give you a sense of whether I am the therapist best suited to meet your needs.
(484) 285-4320 View (484) 285-4320
Photo of Patricia Anne Donoghue, PhD, Psychologist
Patricia Anne Donoghue
Psychologist, PhD
Verified Verified
In over 25 years practicing as a licensed clinical psychologist, I have helped people overcome a wide range of challenges and issues so they can not just survive, but thrive.
In over 25 years practicing as a licensed clinical psychologist, I have helped people overcome a wide range of challenges and issues so they can not just survive, but thrive.
(610) 601-3891 View (610) 601-3891
Photo of Danielle White, Pre-Licensed Professional
Danielle White
Pre-Licensed Professional
Verified Verified
1 Endorsed
Therapy is a gift. It is transformative. It is empowering. And empowering others through warmth, support, compassion, evidence-based therapeutic practices, and psychoeducation is what gets my blood pumping. My fundamental goal is to help you discover the strength and agency within yourself to make important choices which espouse positive change. Emotions can be difficult to navigate. I firmly and emphatically believe that, together, we can identify and employ effective tools which serve as a catalyst for allowing you to experience improved wellness, and enjoy an enduringly elevated quality of life.
Therapy is a gift. It is transformative. It is empowering. And empowering others through warmth, support, compassion, evidence-based therapeutic practices, and psychoeducation is what gets my blood pumping. My fundamental goal is to help you discover the strength and agency within yourself to make important choices which espouse positive change. Emotions can be difficult to navigate. I firmly and emphatically believe that, together, we can identify and employ effective tools which serve as a catalyst for allowing you to experience improved wellness, and enjoy an enduringly elevated quality of life.
(610) 510-8545 View (610) 510-8545
Photo of Taralisa Reinhart, MFT, Pre-Licensed Professional
Taralisa Reinhart
Pre-Licensed Professional, MFT
Verified Verified
Are you feeling overwhelmed by the challenges of parenting your child or teen? Do you feel confused about which latest parenting expert’s advice you should be following? It can be frustrating to figure out which approach feels both best for your child and authentic to you as the parent. As a dedicated therapist with many years of experience treating children and teens with significant emotional and behavioral difficulties, this is where I can help. With a welcoming and candid approach, I create a space where kids feel listened to and parents feel truly supported.
Are you feeling overwhelmed by the challenges of parenting your child or teen? Do you feel confused about which latest parenting expert’s advice you should be following? It can be frustrating to figure out which approach feels both best for your child and authentic to you as the parent. As a dedicated therapist with many years of experience treating children and teens with significant emotional and behavioral difficulties, this is where I can help. With a welcoming and candid approach, I create a space where kids feel listened to and parents feel truly supported.
(610) 819-7195 View (610) 819-7195
Photo of Tamara Gray-Phillips, LMFT, Marriage & Family Therapist
Tamara Gray-Phillips
Marriage & Family Therapist, LMFT
Verified Verified
Chester Springs, PA 19425  (Online Only)
TaMara brings a wealth of experience in an unconventional way. As a former owner of a home healthcare company, that primarily provided services to the elderly, TaMara found herself assisting families, particularly adult children, who had to make tough healthcare and financial decisions for their parent(s). She helped families establish goals on how best to support their parents in maintaining dignity and independence while simultaneously identifying the next steps in the event of their parents’ passing.
TaMara brings a wealth of experience in an unconventional way. As a former owner of a home healthcare company, that primarily provided services to the elderly, TaMara found herself assisting families, particularly adult children, who had to make tough healthcare and financial decisions for their parent(s). She helped families establish goals on how best to support their parents in maintaining dignity and independence while simultaneously identifying the next steps in the event of their parents’ passing.
(610) 590-8277 View (610) 590-8277
Photo of Lara Haagen, MA, ATR-BC, LPC, Licensed Professional Counselor
Lara Haagen
Licensed Professional Counselor, MA, ATR-BC, LPC
Verified Verified
1 Endorsed
Have you ever felt like therapy didn’t quite bring relief, or as if you were ‘failing’ at treatment? Feeling burnt out and unsure why, or facing the challenges of parenting a unique child? You’re not alone and certainly not a failure! Not every therapeutic approach is a fit for everyone, and some can even amplify distress—particularly when neurodiversity goes unrecognized and unsupported. Gaining a deeper understanding of how your mind works and exploring strategies tailored to diverse neurotypes can be transformative, fostering increased confidence, improved behaviors, & enriched relationships for a more fulfilling quality of life.
Have you ever felt like therapy didn’t quite bring relief, or as if you were ‘failing’ at treatment? Feeling burnt out and unsure why, or facing the challenges of parenting a unique child? You’re not alone and certainly not a failure! Not every therapeutic approach is a fit for everyone, and some can even amplify distress—particularly when neurodiversity goes unrecognized and unsupported. Gaining a deeper understanding of how your mind works and exploring strategies tailored to diverse neurotypes can be transformative, fostering increased confidence, improved behaviors, & enriched relationships for a more fulfilling quality of life.
(610) 601-4900 View (610) 601-4900
Photo of Amy Borla, MS MFT, Pre-Licensed Professional
Amy Borla
Pre-Licensed Professional, MS MFT
Verified Verified
1 Endorsed
I believe that every relationship is as unique as the people in it, but sometimes couples fall into common dynamics that damage trust and connection. When things get off track, each person has the ability to reestablish a deep and loving connection -- sometimes it just takes a little help breaking free of those negative patterns.
I believe that every relationship is as unique as the people in it, but sometimes couples fall into common dynamics that damage trust and connection. When things get off track, each person has the ability to reestablish a deep and loving connection -- sometimes it just takes a little help breaking free of those negative patterns.
(484) 559-7647 View (484) 559-7647
Photo of Shelby L Riley - Shelby Riley, LMFT and Associates, LMFT, Marriage & Family Therapist
Shelby Riley, LMFT and Associates
Marriage & Family Therapist, LMFT
Verified Verified
11 Endorsed
Are you feeling anxious, depressed, overwhelmed? Are your intimate relationships not what you hoped they would be? Are you worried about your children's behavior or social skills? There are times in everyone's life when help from a professional can make all the difference. Therapy starts with an effort to get to know you and your concerns. We then work together to create clear goals and form a plan that fits for you.
Are you feeling anxious, depressed, overwhelmed? Are your intimate relationships not what you hoped they would be? Are you worried about your children's behavior or social skills? There are times in everyone's life when help from a professional can make all the difference. Therapy starts with an effort to get to know you and your concerns. We then work together to create clear goals and form a plan that fits for you.
(484) 257-9600 View (484) 257-9600
Photo of Elizabeth Fratantoni - Fratantoni Counseling and Blue Creek Psychotherapy, MA, CAADC, Licensed Professional Counselor
Fratantoni Counseling and Blue Creek Psychotherapy
Licensed Professional Counselor, MA, CAADC
Verified Verified
Not accepting new clients
My ideal client is seeking help with an open mind to gain a better understanding of the underlying issues related to their challenges. Clients interested in addressing issues related to anxiety/depression, social isolation, impulsivity, procrastination, addiction, parenting, family and relationships with the goal to gain self-awareness and coping skills will work well with my counseling approach. My hope is that those that I work with will gain a greater sense of self, improve communication skills, enhance life balance, and develop feelings of self-empowerment.
My ideal client is seeking help with an open mind to gain a better understanding of the underlying issues related to their challenges. Clients interested in addressing issues related to anxiety/depression, social isolation, impulsivity, procrastination, addiction, parenting, family and relationships with the goal to gain self-awareness and coping skills will work well with my counseling approach. My hope is that those that I work with will gain a greater sense of self, improve communication skills, enhance life balance, and develop feelings of self-empowerment.
(484) 207-5477 View (484) 207-5477
Photo of Amber Cardemil, MSW, LCSW, Clinical Social Work/Therapist
Amber Cardemil
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
3 Endorsed
Hello! I’m Amber. I am a Licensed Clinical Social Worker (LCSW) and my training is strengths-based, trauma informed, and recovery-perspective grounded. I have practiced extensively with individuals and families working to make treatment a collaborative process. I specialize in the field of eating disorders treating adolescents and adults, individuals and families. I have worked in all levels of care for over a decade, allowing me to treat an array of symptoms and co-occurring conditions.
Hello! I’m Amber. I am a Licensed Clinical Social Worker (LCSW) and my training is strengths-based, trauma informed, and recovery-perspective grounded. I have practiced extensively with individuals and families working to make treatment a collaborative process. I specialize in the field of eating disorders treating adolescents and adults, individuals and families. I have worked in all levels of care for over a decade, allowing me to treat an array of symptoms and co-occurring conditions.
(610) 600-1463 View (610) 600-1463
Photo of Nancy L Pellegrini, LCSW, Clinical Social Work/Therapist
Nancy L Pellegrini
Clinical Social Work/Therapist, LCSW
Verified Verified
2 Endorsed
Do you find yourself preoccupied, unable to sleep well, or moody and irritable? Have you found it more difficult to get out of bed and face the day with motivation and energy? Have you or others noticed that there is more conflict in your interactions? I have been successful in helping many individuals, couples and families clarify and understand their difficulties, identify strategies for change, and collaboratively work together for problem resolution. My approach is engaging, with an emphasis on reflective listening, giving feedback and information, and empathically supporting the difficult but rewarding process of change.
Do you find yourself preoccupied, unable to sleep well, or moody and irritable? Have you found it more difficult to get out of bed and face the day with motivation and energy? Have you or others noticed that there is more conflict in your interactions? I have been successful in helping many individuals, couples and families clarify and understand their difficulties, identify strategies for change, and collaboratively work together for problem resolution. My approach is engaging, with an emphasis on reflective listening, giving feedback and information, and empathically supporting the difficult but rewarding process of change.
(484) 548-0964 View (484) 548-0964
Photo of Amy Watkins, LPC, CET III, Licensed Professional Counselor
Amy Watkins
Licensed Professional Counselor, LPC, CET III
Verified Verified
I specialize in working with those who have experienced trauma, attachment disorders, and relationship complications (including relationships with high-conflict individuals). My goal is to support you in the journey back to your true self and provide tools that allow you to find your worth, deepening the connection with yourself to have healthier connections with others.
I specialize in working with those who have experienced trauma, attachment disorders, and relationship complications (including relationships with high-conflict individuals). My goal is to support you in the journey back to your true self and provide tools that allow you to find your worth, deepening the connection with yourself to have healthier connections with others.
(610) 439-9613 View (610) 439-9613
Photo of Kristina Vacha, LCSW, LBS, MSS, MA, Clinical Social Work/Therapist
Kristina Vacha
Clinical Social Work/Therapist, LCSW, LBS, MSS, MA
Verified Verified
1 Endorsed
Are you struggling with anxiety, depression or social isolation? Are you overwhelmed by work, family, relationships, or facing major life stressors? Is it hard to feel like you fit in? Are you trying really hard and still left feeling like you aren't good enough? My clients are often feeling stuck and wanting to feel better. I offer a safe place and support so you can learn better ways to cope, reduce symptoms of distress, and move closer to living your best life. My clientele includes adults with autism, both diagnosed or exploring neurodiversity, individuals with chronic illness or individuals facing empty nest/retirement.
Are you struggling with anxiety, depression or social isolation? Are you overwhelmed by work, family, relationships, or facing major life stressors? Is it hard to feel like you fit in? Are you trying really hard and still left feeling like you aren't good enough? My clients are often feeling stuck and wanting to feel better. I offer a safe place and support so you can learn better ways to cope, reduce symptoms of distress, and move closer to living your best life. My clientele includes adults with autism, both diagnosed or exploring neurodiversity, individuals with chronic illness or individuals facing empty nest/retirement.
(484) 212-0888 View (484) 212-0888
1

How does your Therapist compare?

Number of Therapists in 19425

100+

Average cost per session

$150

Therapists in 19425 who prioritize treating:

86% Anxiety
83% Depression
75% Self Esteem
71% Trauma and PTSD
64% Relationship Issues
62% Coping Skills
61% Grief

Average years in practice

12 Years

Top 3 insurances accepted

75% Aetna
67% Optum
65% Cigna and Evernorth

How Therapists in 19425 see their clients

62% In Person and Online
38% Online Only

Gender breakdown

86% Female
13% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in 19425?

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.