Therapists in Aptos, CA

Photo of Roscelia Madrigal, Marriage & Family Therapist in Aptos, CA
Roscelia Madrigal
Marriage & Family Therapist, LMFT , CTT
Verified Verified
2 Endorsed
Aptos, CA 95003
You are pushing through life and aware of what you want but you are stuck. You struggle to apply what you already know leaving you anxious and confused. You are committed to your growth and have a desire to improve but something is blocking you from acheiving your goals. You want to improve your relationship with yourself and your relationships with others, but you need help developing healthier boundaries. You just want to feel happy and be you, but at times you don’t feel You is good enough.
You are pushing through life and aware of what you want but you are stuck. You struggle to apply what you already know leaving you anxious and confused. You are committed to your growth and have a desire to improve but something is blocking you from acheiving your goals. You want to improve your relationship with yourself and your relationships with others, but you need help developing healthier boundaries. You just want to feel happy and be you, but at times you don’t feel You is good enough.
(831) 208-3288 View (831) 208-3288
Photo of Ashley Marie Boyd in Aptos, CA
Ashley Marie Boyd
MHt, MNLP, MSc, MTT, EFT
Verified Verified
1 Endorsed
Aptos, CA 95003
I’m here to help you Create your Dream Life by setting & achieving your goals, overcome blocks, set new patterns & tap into your Alignment, Embodiment & Empowerment. My focus is on guiding you to your inner wisdom, transforming your relationship to self, forming new beliefs & patterns while rediscovering your unique talents. By working together my aim is to support you in achieving your hearts desires, achieving success & helping you flourish in your life. We will take a holistic approach that respects the interconnectedness of mind, body, and spirit. I believe in your innate wisdom, wholeness, resilience, and capacity for growth.
I’m here to help you Create your Dream Life by setting & achieving your goals, overcome blocks, set new patterns & tap into your Alignment, Embodiment & Empowerment. My focus is on guiding you to your inner wisdom, transforming your relationship to self, forming new beliefs & patterns while rediscovering your unique talents. By working together my aim is to support you in achieving your hearts desires, achieving success & helping you flourish in your life. We will take a holistic approach that respects the interconnectedness of mind, body, and spirit. I believe in your innate wisdom, wholeness, resilience, and capacity for growth.
(831) 603-2357 View (831) 603-2357
Photo of Joel Stiles, Psychologist in Aptos, CA
Joel Stiles
Psychologist, PhD
Verified Verified
Aptos, CA 95003
Often life presents us with difficulties and painful challenges. I can help whether your intention is to heal from past or current emotional struggles or to improve relationships. Together we can explore your strengths as well as your difficulties to find solutions. I work with individuals, couples, and families to strengthen relationships and improve communication. I have a strong appreciation for diversity and believe each individual has unique gifts. I am skilled in responding to your individual needs with compassion and respect.
Often life presents us with difficulties and painful challenges. I can help whether your intention is to heal from past or current emotional struggles or to improve relationships. Together we can explore your strengths as well as your difficulties to find solutions. I work with individuals, couples, and families to strengthen relationships and improve communication. I have a strong appreciation for diversity and believe each individual has unique gifts. I am skilled in responding to your individual needs with compassion and respect.
(831) 278-3136 x14 View (831) 278-3136 x14
Photo of Darcy Cavanaugh, Marriage & Family Therapist Associate in Aptos, CA
Darcy Cavanaugh
Marriage & Family Therapist Associate, MA, AMFT, APCC
Verified Verified
Aptos, CA 95003
So glad that you are here. Whether you are struggling with something that has recently arisen, or are ready to dive into healing the past, I am here to support you in your journey. I am a Somatic based psychotherapist who works to integrate trauma through safely accessing the body and mind. LGBTQIA affirmative and diversity oriented, I aim to address underlying systems of power within and surrounding each of us. In doing so, I work in a way that supports and nurtures whatever shows up.
So glad that you are here. Whether you are struggling with something that has recently arisen, or are ready to dive into healing the past, I am here to support you in your journey. I am a Somatic based psychotherapist who works to integrate trauma through safely accessing the body and mind. LGBTQIA affirmative and diversity oriented, I aim to address underlying systems of power within and surrounding each of us. In doing so, I work in a way that supports and nurtures whatever shows up.
(831) 201-1994 View (831) 201-1994
Photo of Jessica Brohmer, Marriage & Family Therapist in Aptos, CA
Jessica Brohmer
Marriage & Family Therapist, LMFT
Verified Verified
2 Endorsed
Aptos, CA 95003  (Online Only)
When someone important to you has died, grief therapy can help unpack the layers of emotions and memories. Every new loss can bring up memories of past losses, and each year the grief can return during anniversaries, birthdays, holidays, and other events. Modern culture often doesn't know what to do with grief, and the people around you don't know how to respond to your sadness and pain, either treating you like you're fragile or expecting you to move on like nothing happened. You need support through your grief where you can process the loss at your own pace.
When someone important to you has died, grief therapy can help unpack the layers of emotions and memories. Every new loss can bring up memories of past losses, and each year the grief can return during anniversaries, birthdays, holidays, and other events. Modern culture often doesn't know what to do with grief, and the people around you don't know how to respond to your sadness and pain, either treating you like you're fragile or expecting you to move on like nothing happened. You need support through your grief where you can process the loss at your own pace.
(831) 219-2285 View (831) 219-2285
Photo of Dr. Kathryn Keithly, Pediatric Psychologist , Psychologist in Aptos, CA
Dr. Kathryn Keithly, Pediatric Psychologist
Psychologist, LEP, MA, PsyD
Verified Verified
Aptos, CA 95003
Kathryn (Katy) Keithly holds a Psy.D. in Clinical Psychology and an M.A. in Counseling Psychology, with a concentration in Educational Psychology and a State certification in School Psychology. She is a licensed Educational Psychologist (#3485) and a Board Certified Sport Psychologist. Katy got her start in Psychology at Cal State Monterey Bay were she graduated with a B.A and was the captain of CSUMB’s women’s golf team for four years. Katy also has been riding horses since she was five and competed throughout the United States.
Kathryn (Katy) Keithly holds a Psy.D. in Clinical Psychology and an M.A. in Counseling Psychology, with a concentration in Educational Psychology and a State certification in School Psychology. She is a licensed Educational Psychologist (#3485) and a Board Certified Sport Psychologist. Katy got her start in Psychology at Cal State Monterey Bay were she graduated with a B.A and was the captain of CSUMB’s women’s golf team for four years. Katy also has been riding horses since she was five and competed throughout the United States.
(831) 269-5705 View (831) 269-5705
Photo of Jan Wright, Marriage & Family Therapist in Aptos, CA
Jan Wright
Marriage & Family Therapist, MA, LMFT
Verified Verified
Aptos, CA 95003
The journey of self-discovery and healing can be challenging and finding someone who is qualified and supportive to accompany you is important. I offer a warm, accepting and nurturing environment in which together we can explore your feelings and thoughts to gain a better understanding of your self and to make positive changes that will allow you to live life more fully. My goal is to understand you as you are and to work with you at your own pace honoring your unique strengths and knowledge.
The journey of self-discovery and healing can be challenging and finding someone who is qualified and supportive to accompany you is important. I offer a warm, accepting and nurturing environment in which together we can explore your feelings and thoughts to gain a better understanding of your self and to make positive changes that will allow you to live life more fully. My goal is to understand you as you are and to work with you at your own pace honoring your unique strengths and knowledge.
(831) 531-7949 x12 View (831) 531-7949 x12
Photo of Sharon Vaughn in Aptos, CA
Sharon Vaughn
MPH, RN, Couples, Coach
Verified Verified
Aptos, CA 95003
I love helping people realize how good they really are rather than staying stuck in their low self-esteem. To be blunt, I’m a smart, deeply experienced, super kind, caregiving Coach. What I really love to do is help women and men solve their anxieties and recover their joy. My goal is to help you uncover your true potential and lead a life that is worth celebrating. If you're looking for extra support and help through a challenging situation or you are just ready to move in a new direction in your life, I look forward to working with you to achieve your goals.
I love helping people realize how good they really are rather than staying stuck in their low self-esteem. To be blunt, I’m a smart, deeply experienced, super kind, caregiving Coach. What I really love to do is help women and men solve their anxieties and recover their joy. My goal is to help you uncover your true potential and lead a life that is worth celebrating. If you're looking for extra support and help through a challenging situation or you are just ready to move in a new direction in your life, I look forward to working with you to achieve your goals.
(831) 215-3273 View (831) 215-3273
Photo of Amy Gregg, Psychologist in Aptos, CA
Amy Gregg
Psychologist, PhD, MA
Verified Verified
Aptos, CA 95003  (Online Only)
I want to hear what you have to say, supporting you with compassion and insight. Who are you at your deepest, truest self? I use the Feeling Good model of CBT and EMDR (Flash and regular EMDR) to help bring awareness to your inner processes, effectively releasing emotion, negative thoughts, and healing trauma. Learn to offer yourself loving kindness and neutrally observe what you are feeling and thinking. Practice self care to to treat yourself as your own best friend. Enlightenment is possible and is an ongoing journey of deepening that awareness.
I want to hear what you have to say, supporting you with compassion and insight. Who are you at your deepest, truest self? I use the Feeling Good model of CBT and EMDR (Flash and regular EMDR) to help bring awareness to your inner processes, effectively releasing emotion, negative thoughts, and healing trauma. Learn to offer yourself loving kindness and neutrally observe what you are feeling and thinking. Practice self care to to treat yourself as your own best friend. Enlightenment is possible and is an ongoing journey of deepening that awareness.
(831) 800-2381 View (831) 800-2381
Photo of Ellen Garfield, LMFT. Specializing in EMDR , Marriage & Family Therapist in Aptos, CA
Ellen Garfield, LMFT. Specializing in EMDR
Marriage & Family Therapist, LMFT
Verified Verified
13 Endorsed
Aptos, CA 95003
IN-PERSON and ZOOM appts available. My style is engaged, curious, warm, direct, and my clients tell me they enjoy my sense of humor. I love working with individuals struggling with conflicts in the family, work, or with friends, those wanting to gain insight into themselves, and individuals in the process of healing from trauma. I have specialized training in EMDR (eye movement desensitization & reprocessing), which is an evidence-based practice shown to be effective in decreasing psychological distress caused by trauma and disturbing life experiences. I also incorporate parts work/IFS. I’m neurodiversity affirming and fat positive.
IN-PERSON and ZOOM appts available. My style is engaged, curious, warm, direct, and my clients tell me they enjoy my sense of humor. I love working with individuals struggling with conflicts in the family, work, or with friends, those wanting to gain insight into themselves, and individuals in the process of healing from trauma. I have specialized training in EMDR (eye movement desensitization & reprocessing), which is an evidence-based practice shown to be effective in decreasing psychological distress caused by trauma and disturbing life experiences. I also incorporate parts work/IFS. I’m neurodiversity affirming and fat positive.
(831) 854-7543 View (831) 854-7543
Photo of Eric Ochoa, Marriage & Family Therapist in Aptos, CA
Eric Ochoa
Marriage & Family Therapist, MA, LMFT
Verified Verified
Aptos, CA 95003
I am committed to helping you find the best clinician for your needs. Feel free to reach out to me and I will listen to your needs and help connect you with someone who can help--whether that is me or another clinician.
I am committed to helping you find the best clinician for your needs. Feel free to reach out to me and I will listen to your needs and help connect you with someone who can help--whether that is me or another clinician.
(831) 201-5326 View (831) 201-5326
Photo of Karen Ouse, Marriage & Family Therapist in Aptos, CA
Karen Ouse
Marriage & Family Therapist, MA, LMFT, SEP, NARM
Verified Verified
3 Endorsed
Aptos, CA 95003
Waitlist for new clients
Are you suffering from the effects of trauma in your life? Are you finding that talk therapy alone is not shifting patterns of mood and behavior? I am a holistic psychotherapist with specialized training in Somatic Experiencing and the Neuro-Affective Relational Model. You may feel as though you don't know who you are any more, that life has become burdensome, or maybe you have the sense that you were never really your authentic self to begin with. Perhaps you experience physiological and behavioral symptoms such as addiction, overwhelm, and isolation. This loss of connection to self/other is indicative of trauma. I can help you.
Are you suffering from the effects of trauma in your life? Are you finding that talk therapy alone is not shifting patterns of mood and behavior? I am a holistic psychotherapist with specialized training in Somatic Experiencing and the Neuro-Affective Relational Model. You may feel as though you don't know who you are any more, that life has become burdensome, or maybe you have the sense that you were never really your authentic self to begin with. Perhaps you experience physiological and behavioral symptoms such as addiction, overwhelm, and isolation. This loss of connection to self/other is indicative of trauma. I can help you.
(831) 216-5398 View (831) 216-5398
Photo of Whitney E Burgess, Marriage & Family Therapist in Aptos, CA
Whitney E Burgess
Marriage & Family Therapist, MA, LMFT
Verified Verified
Aptos, CA 95003  (Online Only)
In my practice, I draw upon evidence-based practices and embrace a holistic approach to therapy. Every intervention I offer is carefully tailored to honor the unique essence of every individual. Whether gently weaving in somatic-focused techniques, delicately navigating interpersonal dynamics, or gently guiding mindfulness practices, my intention is to create a nurturing space for profound healing and transformation to unfold.
In my practice, I draw upon evidence-based practices and embrace a holistic approach to therapy. Every intervention I offer is carefully tailored to honor the unique essence of every individual. Whether gently weaving in somatic-focused techniques, delicately navigating interpersonal dynamics, or gently guiding mindfulness practices, my intention is to create a nurturing space for profound healing and transformation to unfold.
(831) 740-3125 View (831) 740-3125
Photo of Stan Einhorn, Psychologist in Aptos, CA
Stan Einhorn
Psychologist, PhD
Verified Verified
Aptos, CA 95003  (Online Only)
Waitlist for new clients
Hello, thank you for taking the time to see if I am a good fit for you as a therapist. Helping people discover their own solutions to improve their lives is truly rewarding for me. I will help you find your path to these solutions. I offer a safe and accepting space in which we explore the issues that challenge you in the present and how that may relate to emotional burdens of the past. Together we work to heal old wounds so that they no longer negatively impact decisions, relationships, or patterns of behaviors in your present life.
Hello, thank you for taking the time to see if I am a good fit for you as a therapist. Helping people discover their own solutions to improve their lives is truly rewarding for me. I will help you find your path to these solutions. I offer a safe and accepting space in which we explore the issues that challenge you in the present and how that may relate to emotional burdens of the past. Together we work to heal old wounds so that they no longer negatively impact decisions, relationships, or patterns of behaviors in your present life.
(831) 278-4932 View (831) 278-4932
Photo of Raina Rose Gallagher, Associate Clinical Social Worker in Aptos, CA
Raina Rose Gallagher
Associate Clinical Social Worker, ACSW
Verified Verified
1 Endorsed
Aptos, CA 95003
It can be really difficult to ask for help. Even when a helping hand is extended, it can be even harder to hold on and trust. I believe that healing is not a linear process. There will be inevitable ups and downs going through the healing journey, which is where the real progress is made. Continuously being asked to find the courage to get back up over, and over, and over again is where you will find your true inner strength. How do we keep moving forward when it all just feels like too much? Every passing moment is temporary, but it is how we cope with those challenging, stressful, and even scary moments that matter.
It can be really difficult to ask for help. Even when a helping hand is extended, it can be even harder to hold on and trust. I believe that healing is not a linear process. There will be inevitable ups and downs going through the healing journey, which is where the real progress is made. Continuously being asked to find the courage to get back up over, and over, and over again is where you will find your true inner strength. How do we keep moving forward when it all just feels like too much? Every passing moment is temporary, but it is how we cope with those challenging, stressful, and even scary moments that matter.
(831) 703-8983 View (831) 703-8983
Photo of Phyllis Heenan, LCSW, DCSW, Clinical Social Work/Therapist in Aptos, CA
Phyllis Heenan, LCSW, DCSW
Clinical Social Work/Therapist, LCSW, DCSW
Verified Verified
1 Endorsed
Aptos, CA 95003
Not accepting new clients
We all have an inner wisdom and interior life that can inform and transform how we hold and participate in the wonder of our lives. I view psychotherapy as a threshold for those seeking a deeper connection to their own experience. Exploring how these mysterious inner resources manifest in the external environment can make it possible to view our lives from a new vantage point. I support individuals to feel more alive, awake and whole in each moment regardless of their circumstances.
We all have an inner wisdom and interior life that can inform and transform how we hold and participate in the wonder of our lives. I view psychotherapy as a threshold for those seeking a deeper connection to their own experience. Exploring how these mysterious inner resources manifest in the external environment can make it possible to view our lives from a new vantage point. I support individuals to feel more alive, awake and whole in each moment regardless of their circumstances.
(831) 824-5135 View (831) 824-5135
Photo of Patricia Dudley, Marriage & Family Therapist in Aptos, CA
Patricia Dudley
Marriage & Family Therapist, LMFT
Verified Verified
1 Endorsed
Aptos, CA 95003
I work well with motivated clients who are looking to improve their daily lives through self-exploration, and are open to challenging their current patterns in order to reach your goals. Whether you are struggling with depression, anxiety, feeling stuck, work/life stress, relationship issues, past trauma, or managing the daily challenges we are facing during this COVID-19 global shift, I would love to be here to support you. I work primarily with individuals and groups.
I work well with motivated clients who are looking to improve their daily lives through self-exploration, and are open to challenging their current patterns in order to reach your goals. Whether you are struggling with depression, anxiety, feeling stuck, work/life stress, relationship issues, past trauma, or managing the daily challenges we are facing during this COVID-19 global shift, I would love to be here to support you. I work primarily with individuals and groups.
(831) 292-4073 View (831) 292-4073
Photo of Craig Rothhammer, Clinical Social Work/Therapist in Aptos, CA
Craig Rothhammer
Clinical Social Work/Therapist, LCSW
Verified Verified
Aptos, CA 95003  (Online Only)
I am a highly experienced practitioner with 43 years of clinical experience, willing to work with more complex cases. I have a calm demeanor (California beach style) but communicate directly, with transparency and tact. My goal is assist you in developing the skills and insights to approach a vast array of situations., with a higher degree of success. I seek to provide the means to manage immediate issues, but also techniques to become more independent in facing the inevitable future challenges of life. I have seen exclusively Kaiser NorCal clients.
I am a highly experienced practitioner with 43 years of clinical experience, willing to work with more complex cases. I have a calm demeanor (California beach style) but communicate directly, with transparency and tact. My goal is assist you in developing the skills and insights to approach a vast array of situations., with a higher degree of success. I seek to provide the means to manage immediate issues, but also techniques to become more independent in facing the inevitable future challenges of life. I have seen exclusively Kaiser NorCal clients.
(562) 352-1243 View (562) 352-1243
Photo of JoAnna I. Dias, Psychologist in Aptos, CA
JoAnna I. Dias
Psychologist, PsyD, MA
Verified Verified
1 Endorsed
Aptos, CA 95003
Sometimes you have been carrying so much and you need someone to journey with you to help you make sense of what's happening and help you cope in new ways. If you have been struggling with anxiety, depression, relational difficulties, changes in your life, spiritual abuse, or trauma, I would love to support you by giving you a safe space to process and heal.
Sometimes you have been carrying so much and you need someone to journey with you to help you make sense of what's happening and help you cope in new ways. If you have been struggling with anxiety, depression, relational difficulties, changes in your life, spiritual abuse, or trauma, I would love to support you by giving you a safe space to process and heal.
(408) 335-4531 View (408) 335-4531
Photo of Ivan W Foote, Marriage & Family Therapist in Aptos, CA
Ivan W Foote
Marriage & Family Therapist, LMFT
Verified Verified
Aptos, CA 95003
Thank you for viewing my profile. We live in tense and uncertain times and it's easy to get charged up and react in ways that maybe we shouldn't have. Part of my work is to help individuals and couples reduce emotional reactivity that may be causing problems. I often help people examine thoughts and misperceptions that color the way that we see the world and that effect our relationships. Did you grow up during the Cold War era? Are today's occurances in Europe triggering anxieties that you thought were long past and gone for good? You are not alone.
Thank you for viewing my profile. We live in tense and uncertain times and it's easy to get charged up and react in ways that maybe we shouldn't have. Part of my work is to help individuals and couples reduce emotional reactivity that may be causing problems. I often help people examine thoughts and misperceptions that color the way that we see the world and that effect our relationships. Did you grow up during the Cold War era? Are today's occurances in Europe triggering anxieties that you thought were long past and gone for good? You are not alone.
(831) 387-4897 View (831) 387-4897

How does your Therapist compare?

Number of Therapists in Aptos, CA

100+

Average cost per session

$160

Therapists in Aptos, CA who prioritize treating:

90% Anxiety
89% Depression
86% Relationship Issues
75% Self Esteem
71% Trauma and PTSD
70% Grief
63% Coping Skills

Average years in practice

16 Years

Top 3 insurances accepted

33% Aetna
33% Other
31% MHN | Health Net

How Therapists in Aptos, CA see their clients

82% In Person and Online
18% Online Only

Gender breakdown

74% Female
25% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Aptos?

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.