Therapists in Washington, DC
Nicholas Kirsch
Psychologist, PhD
Verified Verified
Washington, DC 20009
In 35 years of practice, my peers have consistently recognized me in WASHINGTONIAN's "Best" therapists. I love my job; I get to connect with patients deepest psyches, sharing intense joy and pain on the path to fuller lives. Therapy involves more openness, vulnerability, and self awareness than you imagined possible as you work through shame, trauma, passivity, dependencies, insecurity, etc. You take responsibility for bad habits, limitations and poor decisions. You take better care of yourself and loved ones, achieve goals, manage stressors, and grieve losses while improving relationships, job performance and decision making.
In 35 years of practice, my peers have consistently recognized me in WASHINGTONIAN's "Best" therapists. I love my job; I get to connect with patients deepest psyches, sharing intense joy and pain on the path to fuller lives. Therapy involves more openness, vulnerability, and self awareness than you imagined possible as you work through shame, trauma, passivity, dependencies, insecurity, etc. You take responsibility for bad habits, limitations and poor decisions. You take better care of yourself and loved ones, achieve goals, manage stressors, and grieve losses while improving relationships, job performance and decision making.
Elizabeth Crunk
Counselor, PhD, NCC, LGPC
Verified Verified
1 Endorsed
Washington, DC 20036
I help adults navigate the challenging experience of coping with grief. Loss is often highly distressing and there is not a duration of time that grieving should take. However, we sometimes feel stuck in our grief or desire support. Because grief is a natural response to loss, the goal of our work together is not to "cure" your grief, but to help you find ways to adjust to your loss and cope with the stressors that accompany it. I also work with clients experiencing relationship and family-of-origin concerns and with individuals who would like to live more authentically and develop greater self-compassion and healthier boundaries.
I help adults navigate the challenging experience of coping with grief. Loss is often highly distressing and there is not a duration of time that grieving should take. However, we sometimes feel stuck in our grief or desire support. Because grief is a natural response to loss, the goal of our work together is not to "cure" your grief, but to help you find ways to adjust to your loss and cope with the stressors that accompany it. I also work with clients experiencing relationship and family-of-origin concerns and with individuals who would like to live more authentically and develop greater self-compassion and healthier boundaries.
Shamara Howze
Licensed Professional Counselor, LPC, LCPC, RPT
Verified Verified
1 Endorsed
Washington, DC 20002
I hope to support you as a caregiver and your child on your journey. No matter how you got here, whether through adjustments, trauma, grief, attachment, divorce, anxiety or other mental health related challenges. I work with both caregiver and child/teen to establish realistic goals that don't lead to a perfect road but one that feels safe enough to travel. This means caregiver presence is important throughout the process as you both explore new ways of being.
I hope to support you as a caregiver and your child on your journey. No matter how you got here, whether through adjustments, trauma, grief, attachment, divorce, anxiety or other mental health related challenges. I work with both caregiver and child/teen to establish realistic goals that don't lead to a perfect road but one that feels safe enough to travel. This means caregiver presence is important throughout the process as you both explore new ways of being.
Mali G Parke - Life Coachmediator
Coach, CPC
Verified Verified
Washington, DC 20009
Are you longing for vitality, a sense of choice or self-love/confidence in your life? Are you looking for authenticity, courageous conversations, resonance or deep trust repair in your relationship/s? Are you hoping to find how to live a meaningful and impactful life? I support authentic, compassionate and empowered relating to yourself and others with courageous journeying opening your full expression, connection and power for change. My clients are individuals, partners, co-parents, educators, caregivers or leaders, teams or groups who want to achieve greater trust, connection, resonance, collaboration and systemic resilience.
Are you longing for vitality, a sense of choice or self-love/confidence in your life? Are you looking for authenticity, courageous conversations, resonance or deep trust repair in your relationship/s? Are you hoping to find how to live a meaningful and impactful life? I support authentic, compassionate and empowered relating to yourself and others with courageous journeying opening your full expression, connection and power for change. My clients are individuals, partners, co-parents, educators, caregivers or leaders, teams or groups who want to achieve greater trust, connection, resonance, collaboration and systemic resilience.
Leonard Brisendine
Licensed Professional Counselor, LPC, MS, CSAC
Verified Verified
Washington, DC 20006 (Online Only)
Hello. My name is Lenny Brisendine. I am credentialed in DC and Virginia as a Licensed Professional Counselor and Certified Substance Abuse Counselor. My professional orientation is based on Cognitive Behavioral Therapy and Mindfulness. I offer online therapy and flexible scheduling including Saturday hours, plus an initial free 15 minute video session so you can decide if we are a good match.
Hello. My name is Lenny Brisendine. I am credentialed in DC and Virginia as a Licensed Professional Counselor and Certified Substance Abuse Counselor. My professional orientation is based on Cognitive Behavioral Therapy and Mindfulness. I offer online therapy and flexible scheduling including Saturday hours, plus an initial free 15 minute video session so you can decide if we are a good match.
Roberta Eisen
Licensed Professional Counselor
Verified Verified
Washington, DC 20016
Being a parent can be one of life’s greatest rewards. It also is one of life’s most challenging responsibilities. My goal is to assist parents and children through the transitions of divorce and beyond to achieve the best outcomes possible.
Being a parent can be one of life’s greatest rewards. It also is one of life’s most challenging responsibilities. My goal is to assist parents and children through the transitions of divorce and beyond to achieve the best outcomes possible.
RedemptionTriple-C
Counselor, MHS, MA, NCC, LPC
Verified Verified
Washington, DC 20016
Are you suffering with anxiety, anger, severe grief, or relationship issues? Is your child experiencing behavior or academic issues in school? Is your partner in the throes of addiction, while creating a stressful environment at home? Maybe it's trauma, or a social issue that you or a family member is dealing with. I can help you create a plan that will leave you feeling supported, as opposed to just being heard. I am a highly skilled mental health clinician who understands the challenges of today's highly stressed world. Together, the solution awaits us!
Are you suffering with anxiety, anger, severe grief, or relationship issues? Is your child experiencing behavior or academic issues in school? Is your partner in the throes of addiction, while creating a stressful environment at home? Maybe it's trauma, or a social issue that you or a family member is dealing with. I can help you create a plan that will leave you feeling supported, as opposed to just being heard. I am a highly skilled mental health clinician who understands the challenges of today's highly stressed world. Together, the solution awaits us!
Silver Lake Psychology--Washington DC location
Psychologist, PsyD
Verified Verified
Washington, DC 20009
Learn how to feel more connected to yourself, others and the world around you. Therapy provides all the elements of intimacy: honest communication, vulnerability and trust. Good therapy is challenging yet warm, providing both structure and empathy for your unique experience. We are a collective of therapists with a wide range of specialties. Our intake professionals will help connect you with the right therapist for your needs. We make appointments easy, offering evenings and weekends and flexibility for creative professionals who can't make the same time each week.
Learn how to feel more connected to yourself, others and the world around you. Therapy provides all the elements of intimacy: honest communication, vulnerability and trust. Good therapy is challenging yet warm, providing both structure and empathy for your unique experience. We are a collective of therapists with a wide range of specialties. Our intake professionals will help connect you with the right therapist for your needs. We make appointments easy, offering evenings and weekends and flexibility for creative professionals who can't make the same time each week.
Nicole Wishneff
Clinical Social Work/Therapist, LCSW
Verified Verified
Washington, DC 20005 (Online Only)
I have over 10 years of experience helping individuals manage substance use and mental health challenges. My clinical experience includes providing behavioral health services to a diverse population of adults in outpatient programs, residential treatment facilities, and holistic treatment settings. I have a compassionate, solution-focused therapeutic approach and utilize my experience to help individuals reclaim their power, increase self-awareness, and develop effective coping strategies to live healthy, fulfilling lives. I am passionate about educating others on the role of nutrition in mental health and addiction.
I have over 10 years of experience helping individuals manage substance use and mental health challenges. My clinical experience includes providing behavioral health services to a diverse population of adults in outpatient programs, residential treatment facilities, and holistic treatment settings. I have a compassionate, solution-focused therapeutic approach and utilize my experience to help individuals reclaim their power, increase self-awareness, and develop effective coping strategies to live healthy, fulfilling lives. I am passionate about educating others on the role of nutrition in mental health and addiction.
Genevieve Kozne
Psychologist, PhD
Verified Verified
1 Endorsed
Washington, DC 20002
Not accepting new clients
Being human is hard, and is only made harder in the many challenges life can throw your way. In our work together, we will build insight into what patterns you use to navigate life’s challenges, how you learned those ways of being, and how they aren’t working for you now. Through this insight, we will build up your compassion for yourself while finding new tools that will leave you feeling more satisfied, capable, and connected in your life.
Being human is hard, and is only made harder in the many challenges life can throw your way. In our work together, we will build insight into what patterns you use to navigate life’s challenges, how you learned those ways of being, and how they aren’t working for you now. Through this insight, we will build up your compassion for yourself while finding new tools that will leave you feeling more satisfied, capable, and connected in your life.
Debra Turkat
Clinical Social Work/Therapist
Verified Verified
Washington, DC 20001 (Online Only)
I can help individuals improve their quality of life. Depression, anxiety, relationship conflict, career difficulties, life transitions, parenting frustrations, caregiving for a loved one… these are some of the issues that cause us to lose our equilibrium. To move forward in the most constructive way, and reestablish equilibrium, we will work together using CBT (cognitive behavior therapy,) my principle area of expertise. We will look at behaviors that aren’t working for you and you will replace them with behaviors that improve your daily life.
I can help individuals improve their quality of life. Depression, anxiety, relationship conflict, career difficulties, life transitions, parenting frustrations, caregiving for a loved one… these are some of the issues that cause us to lose our equilibrium. To move forward in the most constructive way, and reestablish equilibrium, we will work together using CBT (cognitive behavior therapy,) my principle area of expertise. We will look at behaviors that aren’t working for you and you will replace them with behaviors that improve your daily life.
15 Second Videos
Nicholas Kirsch
Leonard Brisendine
Roberta Eisen
Debra Turkat
Daniel J Paulus
Elizabeth Melnikoff
Bloomed Within LLC
Lindsay A. Perrin
Cara N. Burton
Allyson Watson
Simone Harris
Jamie Hunt
Sophy Varghese
Ryan Long
Glen Bradley
Sasha Varner
Karin Arndt
Dustin Winkel
Dionna Langford
Kelsey Bates
Laura Reid Harris
Eric Jones
Greenhouse Psychotherapy
Keith A Kaufman
Erika DuBois
Collin Vernay
Jessica Cetoute
Maury L. Joseph
Sara Moore Kerai
Emily Harter
Oluwatimilein E Bamgbola
Cammy | Bliss In Being
Gigi Bell
Bloom Counseling - Liz Caritj
180 Urban Wellness, LLC
Hemi Hunt
Healing Through Therapy, LLC
Stephanie A Lopetegui
Stacey Mayo
Michael A Kaufman
Jamie Keaton Jones
Sarah Hoops
Evan Tokarz
Su Balasubramanian
Stephanie O'Brien
Marissa Nelson
Sarah W Jones
Gotel & Thrive, PLLC
Jenn Hudak
Ashley Acosta
Denise Jones
Clinical Social Work/Therapist, MSW, LICSW, LCSW-C, LCSW
Verified Verified
3 Endorsed
Washington, DC 20003 (Online Only)
As an EMDR Certified Therapist and Consultant, I use EMDR with clients who want an effective and clear-cut method to overcome the challenges of complex-PTSD, depression, and anxiety that can arise from relationship issues, life transitions, occupational plight, or issues of family, social, and cultural duress. In practice for over ten years, I am more than EMDR-trained. I exclusively use EMDR therapy with my clients, and I am actively connected to a national and international network of professionals dedicated to advancing EMDR treatment, research, and protocols. I also provide EMDR consultations for therapists.
As an EMDR Certified Therapist and Consultant, I use EMDR with clients who want an effective and clear-cut method to overcome the challenges of complex-PTSD, depression, and anxiety that can arise from relationship issues, life transitions, occupational plight, or issues of family, social, and cultural duress. In practice for over ten years, I am more than EMDR-trained. I exclusively use EMDR therapy with my clients, and I am actively connected to a national and international network of professionals dedicated to advancing EMDR treatment, research, and protocols. I also provide EMDR consultations for therapists.
Ean Lischin-Smith
Clinical Social Work/Therapist, LICSW, LCSW-C
Verified Verified
Washington, DC 20006
My approach to therapy is compassionate, collaborative, holistic and individualized, meeting you where you are. I am passionate about the process of therapy and will help you to develop insight, identify and reach your goals and enhance wellness. I specialize in treating couples and individuals coping with mental health and relationship concerns. My aim is to engage in collaboration to illuminate, foster insight and clarify what is within as well as the path ahead.
My approach to therapy is compassionate, collaborative, holistic and individualized, meeting you where you are. I am passionate about the process of therapy and will help you to develop insight, identify and reach your goals and enhance wellness. I specialize in treating couples and individuals coping with mental health and relationship concerns. My aim is to engage in collaboration to illuminate, foster insight and clarify what is within as well as the path ahead.
Colleen Sandick
Clinical Social Work/Therapist, LCSW, LICSW, LCSW-C
Verified Verified
3 Endorsed
Washington, DC 20036 (Online Only)
My caseload is full of dynamic and wonderful clients who seek to change the way they relate to themselves, their life circumstances, and their relationships. I have a particular interest working with recovering alcoholics actively working their 12-step program but are "just feeling stuck". In addition, I especially enjoy supporting women seeking to be authentic to themselves and those around them. Together, we will identify your goals and I will support you in pursuing your personal growth, finding your own answers and balance, and identifying and resolving how your past may be unconsciously impacting your day-to-day life.
My caseload is full of dynamic and wonderful clients who seek to change the way they relate to themselves, their life circumstances, and their relationships. I have a particular interest working with recovering alcoholics actively working their 12-step program but are "just feeling stuck". In addition, I especially enjoy supporting women seeking to be authentic to themselves and those around them. Together, we will identify your goals and I will support you in pursuing your personal growth, finding your own answers and balance, and identifying and resolving how your past may be unconsciously impacting your day-to-day life.
Margot Lamson
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
1 Endorsed
Washington, DC 20009
No matter how much you do, that inner-voice insists, “you could be doing more.” You convince yourself you just need to work harder, sleep a little less, spread yourself more thin. Then you’ll finally feel that sense of accomplishment. But the more you do, the louder the voice gets. The weight of the constant stress is exhausting. The tension headache at the base of your skull won’t go away. You can’t control your emotions– the other day you blew up at your best friend. Your mother keeps calling; she’s worried about you. You’ve sacrificed so much, but don’t know what it’s all for. This can’t go on.
No matter how much you do, that inner-voice insists, “you could be doing more.” You convince yourself you just need to work harder, sleep a little less, spread yourself more thin. Then you’ll finally feel that sense of accomplishment. But the more you do, the louder the voice gets. The weight of the constant stress is exhausting. The tension headache at the base of your skull won’t go away. You can’t control your emotions– the other day you blew up at your best friend. Your mother keeps calling; she’s worried about you. You’ve sacrificed so much, but don’t know what it’s all for. This can’t go on.
Katie Graczyk
Licensed Professional Counselor, LPC, PMH-C
Verified Verified
Washington, DC 20036
Currently accepting telehealth clients for Tuesday mornings! Perinatal mood and anxiety disorders are the most under-diagnosed obstetric complication in the US. Current estimates are that up to 1 in 5 women will fight depression postpartum and that non-gestational parents are also at an increased risk for depression and anxiety. While the "baby-blues" effect up to 80% of new moms, depression differs in its intensity and other key features. Early and expert therapeutic care is incredibly helpful in reducing these symptoms of anxiety and depression and carving out a new identity in the world's most difficult role-that of parent.
Currently accepting telehealth clients for Tuesday mornings! Perinatal mood and anxiety disorders are the most under-diagnosed obstetric complication in the US. Current estimates are that up to 1 in 5 women will fight depression postpartum and that non-gestational parents are also at an increased risk for depression and anxiety. While the "baby-blues" effect up to 80% of new moms, depression differs in its intensity and other key features. Early and expert therapeutic care is incredibly helpful in reducing these symptoms of anxiety and depression and carving out a new identity in the world's most difficult role-that of parent.
Dr. Emily Green
Psychologist, PsyD
Verified Verified
1 Endorsed
Washington, DC 20008
Not accepting new clients
As a clinician, I am focused on helping clients find a life of meaning and value. Often times in our pain there is incredibly useful information about what's important to us. As humans, we have evolved to move away from physical pain, to escape it: and for most types of pain, those methods work! But for emotional pain, avoidance not only doesn’t get rid of our pain and suffering, it often amplifies it. In discovering how each individual client finds meaning in their lives, we ground ourselves in the willingness to walk toward our pain, rather than away from it. It is in this space that we find healing and meaningful change.
As a clinician, I am focused on helping clients find a life of meaning and value. Often times in our pain there is incredibly useful information about what's important to us. As humans, we have evolved to move away from physical pain, to escape it: and for most types of pain, those methods work! But for emotional pain, avoidance not only doesn’t get rid of our pain and suffering, it often amplifies it. In discovering how each individual client finds meaning in their lives, we ground ourselves in the willingness to walk toward our pain, rather than away from it. It is in this space that we find healing and meaningful change.
Dr. Kimberly M. Martin, HSPP, LLC
Psychologist, PsyD
Verified Verified
2 Endorsed
Washington, DC 20003
I utilize individual approaches when working with adults to address concerns related to phase-of-life difficulties, depression, anxiety, prolonged stress, and unresolved traumas. My overall goal as a psychologist is to help individuals develop skills and understanding to improve the quality of their life. The ideal client is an individual who is driven toward self-improvement, desires an end to their difficulties, accepts ownership of their behaviors and actions, and wants to identify the root cause of their current concerns and develop effective understanding and coping skills. www.drkimberlym.com
I utilize individual approaches when working with adults to address concerns related to phase-of-life difficulties, depression, anxiety, prolonged stress, and unresolved traumas. My overall goal as a psychologist is to help individuals develop skills and understanding to improve the quality of their life. The ideal client is an individual who is driven toward self-improvement, desires an end to their difficulties, accepts ownership of their behaviors and actions, and wants to identify the root cause of their current concerns and develop effective understanding and coping skills. www.drkimberlym.com
Jonathan Christophel
Clinical Social Work/Therapist, LICSW
Verified Verified
Washington, DC 20036
I look forward to working with you, or your children, in overcoming current obstacles and life challenges. In my experience in working with adults, children, and families, they have all the strengths and resources they need within themselves, and can reach their full potential within a safe, empathic therapeutic relationship.
I look forward to working with you, or your children, in overcoming current obstacles and life challenges. In my experience in working with adults, children, and families, they have all the strengths and resources they need within themselves, and can reach their full potential within a safe, empathic therapeutic relationship.
Morgan Christie
Psychologist, PhD
Verified Verified
2 Endorsed
Washington, DC 20036 (Online Only)
Hello! I am a licensed psychologist working online with adults (both individuals and couples) in Maryland, DC, and Ohio. I provide evidence-based treatment for anxiety, depression, trauma, gender-affirming care, body affirmation and wellness, and identity development. My collaborative approach with clients allows us to build a strong connection in treatment, creating a space where clients feel safe and understood. We will work together to identify goals for therapy, develop helpful coping skills, and process life events in meaningful ways.
Hello! I am a licensed psychologist working online with adults (both individuals and couples) in Maryland, DC, and Ohio. I provide evidence-based treatment for anxiety, depression, trauma, gender-affirming care, body affirmation and wellness, and identity development. My collaborative approach with clients allows us to build a strong connection in treatment, creating a space where clients feel safe and understood. We will work together to identify goals for therapy, develop helpful coping skills, and process life events in meaningful ways.
See more therapy options for Washington
How does your Therapist compare?
Number of Therapists in Washington, DC
2,000+
Average cost per session
$180
Therapists in Washington, DC who prioritize treating:
93% | Anxiety |
89% | Depression |
81% | Relationship Issues |
77% | Self Esteem |
68% | Trauma and PTSD |
68% | Stress |
65% | Coping Skills |
Average years in practice
13 Years
Top 3 insurances accepted
62% | BlueCross and BlueShield |
57% | CareFirst |
53% | Cigna and Evernorth |
How Therapists in Washington, DC see their clients
55% | In Person and Online | |
45% | Online Only |
Gender breakdown
80% | Female | |
19% | Male | |
1% | Non-Binary |
FAQs - About Therapy and Counseling
How can I find a therapist in Washington?
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
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.
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.
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.