Therapists in Dubuque, IA

Photo of Brandee Kohnen (Rus), LISW, Counselor
Brandee Kohnen (Rus)
Counselor, LISW
Verified Verified
1 Endorsed
Dubuque, IA 52001
Do you find yourself staring at the mirror comparing yourself to others, questioning the decisions you’re making, and experiencing fearful thinking about how to make change or the idea of change itself? Your world is full of chaos that whirls more out of control each day and the more you try to hold on the more difficult it seems to keep your grip. Like your body isn’t able to support you or keep up with you- creating fear, anxiety, and other feelings you can’t even begin to describe. Like the mirror in front of you is cracking in a million directions and you don’t know how to fix the image of the person standing in front of you.
Do you find yourself staring at the mirror comparing yourself to others, questioning the decisions you’re making, and experiencing fearful thinking about how to make change or the idea of change itself? Your world is full of chaos that whirls more out of control each day and the more you try to hold on the more difficult it seems to keep your grip. Like your body isn’t able to support you or keep up with you- creating fear, anxiety, and other feelings you can’t even begin to describe. Like the mirror in front of you is cracking in a million directions and you don’t know how to fix the image of the person standing in front of you.
(563) 204-2535 View (563) 204-2535
Photo of Mackenzie Baker, LMSW, Clinical Social Work/Therapist
Mackenzie Baker
Clinical Social Work/Therapist, LMSW
Verified Verified
Dubuque, IA 52002
Navigating the challenges of life can be incredibly demanding, and I wholeheartedly recognize the courage and vulnerability it takes to reach out. My aim for you as the client is to establish a secure and validating environment where you feel comfortable being your true self. Ensuring a sense of safety within the therapy setting is crucial for undertaking the challenging journey of healing and personal growth. I am committed to fostering a non-judgmental and encouraging atmosphere for your journey.
Navigating the challenges of life can be incredibly demanding, and I wholeheartedly recognize the courage and vulnerability it takes to reach out. My aim for you as the client is to establish a secure and validating environment where you feel comfortable being your true self. Ensuring a sense of safety within the therapy setting is crucial for undertaking the challenging journey of healing and personal growth. I am committed to fostering a non-judgmental and encouraging atmosphere for your journey.
(563) 316-6046 View (563) 316-6046
Photo of Alexia Thompson, LMHC, CADC, Counselor
Alexia Thompson
Counselor, LMHC, CADC
Verified Verified
1 Endorsed
Dubuque, IA 52003
I am a Licensed Mental Health Counselor, Certified Alcohol and Drug Counselor and Certified EMDR therapist with over 15 years of clinical experience with adults and adolescents I incorporate a strength based, and integrative approach. I love to work with people who have the desire to live a more fulfilling life with the understanding of how difficult change can be.
I am a Licensed Mental Health Counselor, Certified Alcohol and Drug Counselor and Certified EMDR therapist with over 15 years of clinical experience with adults and adolescents I incorporate a strength based, and integrative approach. I love to work with people who have the desire to live a more fulfilling life with the understanding of how difficult change can be.
(563) 921-6379 View (563) 921-6379
Photo of Amy Steve, LISW, Clinical Social Work/Therapist
Amy Steve
Clinical Social Work/Therapist, LISW
Verified Verified
2 Endorsed
Dubuque, IA 52001
Waitlist for new clients
Life’s journey can create many experiences leading us through paths of adventure and also challenge. When faced with difficulties/hardships in life, the road can often leave us feeling isolated, lonely, ashamed, weak, unloved, and even broken. My name is Amy Steve. I am a licensed Independent Social Worker, but more importantly, I am a mental health therapist and individual that cares deeply about helping children, adolescents, and adults overcome roadblocks that they may face on their journey through life. I believe that each person is unique and that is why treatment will be individually tailored to meet your specific needs.
Life’s journey can create many experiences leading us through paths of adventure and also challenge. When faced with difficulties/hardships in life, the road can often leave us feeling isolated, lonely, ashamed, weak, unloved, and even broken. My name is Amy Steve. I am a licensed Independent Social Worker, but more importantly, I am a mental health therapist and individual that cares deeply about helping children, adolescents, and adults overcome roadblocks that they may face on their journey through life. I believe that each person is unique and that is why treatment will be individually tailored to meet your specific needs.
(563) 202-5412 x1 View (563) 202-5412 x1
Photo of Rachel Nauman, LMSW, APSW, Clinical Social Work/Therapist
Rachel Nauman
Clinical Social Work/Therapist, LMSW, APSW
Verified Verified
Dubuque, IA 52001
The world is a scary place right now. It is more important than ever to make sure that we have our safe space to process through life's curveballs. Stress? Life Changes? Depression? Anxiety? Anger? Mood Changes? I am here for you. I focus on creating a laid-back, empathetic, and empowering space no matter who walks through my door. You are the master of your life. I will identify your strengths to encourage problem solving to help work towards your goals.
The world is a scary place right now. It is more important than ever to make sure that we have our safe space to process through life's curveballs. Stress? Life Changes? Depression? Anxiety? Anger? Mood Changes? I am here for you. I focus on creating a laid-back, empathetic, and empowering space no matter who walks through my door. You are the master of your life. I will identify your strengths to encourage problem solving to help work towards your goals.
(563) 412-5470 View (563) 412-5470
Photo of Abby N Bottorff, MA, LMHC, Counselor
Abby N Bottorff
Counselor, MA, LMHC
Verified Verified
1 Endorsed
Dubuque, IA 52001
My approach to counseling is guided by self-empowerment and embracing the person you are and the ways you’d like to foster a kinder relationship with yourself. Our work together will be tailored to the parts of you that you’d like to better understand and support. This may include deep exploration of sexuality, gender, spirituality, culture, and the many different experiences that create the “parts” of who we are. My space is anti-capitalist and fueled by radical self-acceptance.
My approach to counseling is guided by self-empowerment and embracing the person you are and the ways you’d like to foster a kinder relationship with yourself. Our work together will be tailored to the parts of you that you’d like to better understand and support. This may include deep exploration of sexuality, gender, spirituality, culture, and the many different experiences that create the “parts” of who we are. My space is anti-capitalist and fueled by radical self-acceptance.
(563) 204-8235 View (563) 204-8235
Photo of Mindy J Finn, MS, LMHC, Counselor
Mindy J Finn
Counselor, MS, LMHC
Verified Verified
Dubuque, IA 52003
Mindy Finn is a Licensed Mental Health Counselor in the state of Iowa. She has a Master’s Degree in Counseling Psychology from University of Wisconsin-Platteville. Mindy operates from a strengths-based, client-centered approach to empower her clients, promote positive self-image, and improve interpersonal relationships. She is experienced in treating adults, adolescents, children, families, and couples. Mindy specializes in treating trauma, PTSD, depression, anxiety, mood disorders, life adjustment issues, family and relationship issues.
Mindy Finn is a Licensed Mental Health Counselor in the state of Iowa. She has a Master’s Degree in Counseling Psychology from University of Wisconsin-Platteville. Mindy operates from a strengths-based, client-centered approach to empower her clients, promote positive self-image, and improve interpersonal relationships. She is experienced in treating adults, adolescents, children, families, and couples. Mindy specializes in treating trauma, PTSD, depression, anxiety, mood disorders, life adjustment issues, family and relationship issues.
(563) 921-6348 View (563) 921-6348
Photo of Valerie Gill, LISW, MSW, Clinical Social Work/Therapist
Valerie Gill
Clinical Social Work/Therapist, LISW, MSW
Verified Verified
Dubuque, IA 52001
With over 25 years of social work experience, my empathetic approach compassionately and openly builds upon client strengths to foster a collaborative working relationship. I am a strong advocate and go the extra mile for my clients. Together, we can create positive change for you to meet your life goals. My clients describe me as “skilled, experienced, direct, and caring”. I comfortably address trauma, sexual abuse, domestic violence, depression, anxiety, life transitions, LGBTQ+, grief, and loss. I work well with individuals, adolescents, families, and couples.
With over 25 years of social work experience, my empathetic approach compassionately and openly builds upon client strengths to foster a collaborative working relationship. I am a strong advocate and go the extra mile for my clients. Together, we can create positive change for you to meet your life goals. My clients describe me as “skilled, experienced, direct, and caring”. I comfortably address trauma, sexual abuse, domestic violence, depression, anxiety, life transitions, LGBTQ+, grief, and loss. I work well with individuals, adolescents, families, and couples.
(563) 235-2853 View (563) 235-2853
Photo of Lynne Lutze, PhD, LMHC, LPC, NBCC, Counselor
Lynne Lutze
Counselor, PhD, LMHC, LPC, NBCC
Verified Verified
Dubuque, IA 52003
Do you ever feel so overwhelmed with life that you're not sure where to go or who to turn too? Stressed, anxious, alone, added with frustration, heartbreak, and grief? It's okay to feel and sometimes you need to tell someone exactly how you're doing without being judged or told "Get over it". Sometimes you need a quick reminder that you are human and life can be difficult. If you want to learn how to cope, and live feeling more positive, I am the therapist for you. I work with all age levels and backgrounds and have been in the counseling field since 2006.
Do you ever feel so overwhelmed with life that you're not sure where to go or who to turn too? Stressed, anxious, alone, added with frustration, heartbreak, and grief? It's okay to feel and sometimes you need to tell someone exactly how you're doing without being judged or told "Get over it". Sometimes you need a quick reminder that you are human and life can be difficult. If you want to learn how to cope, and live feeling more positive, I am the therapist for you. I work with all age levels and backgrounds and have been in the counseling field since 2006.
(563) 228-8828 View (563) 228-8828
Photo of Molly Zogas, t-LMHC, Clinical Social Work/Therapist
Molly Zogas
Clinical Social Work/Therapist, t-LMHC
Verified Verified
Dubuque, IA 52002
Life can be challenging, but you don’t have to do it alone. It’s okay to feel difficult emotions. Sometimes, it can be helpful to share those things with another person in a judgment-free space. I will provide a safe, open, and trusting environment so you feel welcomed and encouraged to be yourself. Whether you are experiencing anxiety, depression, grief, trauma, or other challenging feelings, we can work together to help you process and learn skills to allow you the opportunity to be fulfilled in your life.
Life can be challenging, but you don’t have to do it alone. It’s okay to feel difficult emotions. Sometimes, it can be helpful to share those things with another person in a judgment-free space. I will provide a safe, open, and trusting environment so you feel welcomed and encouraged to be yourself. Whether you are experiencing anxiety, depression, grief, trauma, or other challenging feelings, we can work together to help you process and learn skills to allow you the opportunity to be fulfilled in your life.
(563) 649-4362 View (563) 649-4362
Photo of Amber Teubert - Serenity Therapy, LLC, LPC-WI, LMHC-IA, LCPC-IL, NCC, CCMHC, Counselor
Serenity Therapy, LLC
Counselor, LPC-WI, LMHC-IA, LCPC-IL, NCC, CCMHC
Verified Verified
1 Endorsed
Dubuque, IA 52001  (Online Only)
I offer individual adult mental health counseling to those navigating complex issues such as abandonment, abusive relationships, anxiety disorders and trauma. My practice supports clients in achieving body acceptance, building confidence, and managing anxiety effectively. I specialize in trauma recovery, including domestic violence and sexual assault, and provide a safe space for exploring gender identity and transition. LGBTQ+ individuals, celebrities, and public figures are welcome, as well as therapists seeking support. Together, we work towards self-acceptance, improved self-esteem, and a deeper understanding of oneself.
I offer individual adult mental health counseling to those navigating complex issues such as abandonment, abusive relationships, anxiety disorders and trauma. My practice supports clients in achieving body acceptance, building confidence, and managing anxiety effectively. I specialize in trauma recovery, including domestic violence and sexual assault, and provide a safe space for exploring gender identity and transition. LGBTQ+ individuals, celebrities, and public figures are welcome, as well as therapists seeking support. Together, we work towards self-acceptance, improved self-esteem, and a deeper understanding of oneself.
(563) 557-6869 View (563) 557-6869
Photo of Valerie Weiser, LMSW, Clinical Social Work/Therapist
Valerie Weiser
Clinical Social Work/Therapist, LMSW
Verified Verified
1 Endorsed
Dubuque, IA 52001
I promise you there is something worse out there than being sad and that is being alone and being sad. Ain't nobody in this room alone. -Ted Lasso. We are born with all the emotions, but no idea how to manage those emotions. We learn ways to deal with them through life experiences; some helpful ways, some hurtful ways. With every new life experience comes bigger, more complex emotions; pretty soon we feel anxious, overwhelmed, or out of control. Then what the heck do we do? Through our therapeutic relationship, we can work to explore and integrate emotions, and help you to live the life you want to live.
I promise you there is something worse out there than being sad and that is being alone and being sad. Ain't nobody in this room alone. -Ted Lasso. We are born with all the emotions, but no idea how to manage those emotions. We learn ways to deal with them through life experiences; some helpful ways, some hurtful ways. With every new life experience comes bigger, more complex emotions; pretty soon we feel anxious, overwhelmed, or out of control. Then what the heck do we do? Through our therapeutic relationship, we can work to explore and integrate emotions, and help you to live the life you want to live.
(563) 500-2029 View (563) 500-2029
Photo of Connie Marie Sprimont, LISW, Clinical Social Work/Therapist
Connie Marie Sprimont
Clinical Social Work/Therapist, LISW
Verified Verified
2 Endorsed
Dubuque, IA 52001
Hi, I am Connie Sprimont, an empathetic Licensed Independent Social Worker (LISW) passionate about helping individuals navigate life's challenges and cultivate resilience. With over 29 years of experience, I offer a safe and non-judgmental space where you can explore your journey of personal growth. I hold an MSW degree from the University of Iowa, with a focus on clinical social work practice, equipping me with the knowledge and skills to support you effectively. Throughout my career, I have had the privilege of empowering clients to overcome anxiety, depression, trauma, relationship difficulties, grief/loss, and life transitions.
Hi, I am Connie Sprimont, an empathetic Licensed Independent Social Worker (LISW) passionate about helping individuals navigate life's challenges and cultivate resilience. With over 29 years of experience, I offer a safe and non-judgmental space where you can explore your journey of personal growth. I hold an MSW degree from the University of Iowa, with a focus on clinical social work practice, equipping me with the knowledge and skills to support you effectively. Throughout my career, I have had the privilege of empowering clients to overcome anxiety, depression, trauma, relationship difficulties, grief/loss, and life transitions.
(563) 363-6294 View (563) 363-6294
Photo of Nicole Makovec, LISW, Clinical Social Work/Therapist
Nicole Makovec
Clinical Social Work/Therapist, LISW
Verified Verified
1 Endorsed
Dubuque, IA 52002
I have more than 15 years of experience in counseling and case management, and I enjoy empowering and lifting up each person I am privileged to serve. My office is a safe, confidential space where we can work together to build a treatment plan that is the best fit for you. I utilize several approaches in my sessions, including Cognitive Behavioral Therapy (CBT) and solution-based therapy, all with a holistic approach that meets the individual needs of my clients. I proudly serve Iowans of all ages and backgrounds, with a strengths-based approach in my practice.
I have more than 15 years of experience in counseling and case management, and I enjoy empowering and lifting up each person I am privileged to serve. My office is a safe, confidential space where we can work together to build a treatment plan that is the best fit for you. I utilize several approaches in my sessions, including Cognitive Behavioral Therapy (CBT) and solution-based therapy, all with a holistic approach that meets the individual needs of my clients. I proudly serve Iowans of all ages and backgrounds, with a strengths-based approach in my practice.
(563) 239-6845 View (563) 239-6845
Photo of Chris Chandler, MA, LPCC, LMHC, CSAT-S, Counselor
Chris Chandler
Counselor, MA, LPCC, LMHC, CSAT-S
Verified Verified
1 Endorsed
Dubuque, IA 52001  (Online Only)
My passion is helping people build healthy and meaningful lives. I am a Certified Sexual Addiction Therapist trained by Dr. Patrick Carnes, the pioneer in the field of sex addiction. I have extensive experience working with individuals struggling with all forms of addictions and compulsive behaviors including: sex, pornography, drugs, alcohol, food, work, spending, codependent relationships, etc. I use Internal Family Systems, and Lifespan Integration to help people become free from underlying relational/attachment wounds.
My passion is helping people build healthy and meaningful lives. I am a Certified Sexual Addiction Therapist trained by Dr. Patrick Carnes, the pioneer in the field of sex addiction. I have extensive experience working with individuals struggling with all forms of addictions and compulsive behaviors including: sex, pornography, drugs, alcohol, food, work, spending, codependent relationships, etc. I use Internal Family Systems, and Lifespan Integration to help people become free from underlying relational/attachment wounds.
(563) 412-2893 View (563) 412-2893
Photo of Jennifer Dolson, LMHC, Counselor
Jennifer Dolson
Counselor, LMHC
Verified Verified
Dubuque, IA 52002  (Online Only)
Wherever you are on your journey to healing, I’m ready to provide a listening ear and a safe space where we can work together and help you achieve your goals. I have experience serving individuals, couples, and families, and I’ll collaborate with you to build a therapy plan that works for you and your schedule. I am available to meet with you in-person or via video teletherapy.
Wherever you are on your journey to healing, I’m ready to provide a listening ear and a safe space where we can work together and help you achieve your goals. I have experience serving individuals, couples, and families, and I’ll collaborate with you to build a therapy plan that works for you and your schedule. I am available to meet with you in-person or via video teletherapy.
(563) 513-2586 View (563) 513-2586
Photo of Daniel Finn, LISW, Clinical Social Work/Therapist
Daniel Finn
Clinical Social Work/Therapist, LISW
Verified Verified
Dubuque, IA 52001
An effective therapeutic experience is a partnership between client and therapist. I enjoy being witness to an individuals recovery from various struggles brought on by the human condition. My belief in strength and resiliency has served as an important cornerstone in my approach to therapy.
An effective therapeutic experience is a partnership between client and therapist. I enjoy being witness to an individuals recovery from various struggles brought on by the human condition. My belief in strength and resiliency has served as an important cornerstone in my approach to therapy.
(563) 239-5285 View (563) 239-5285
Photo of Ashlee Weber, LMHC, Counselor
Ashlee Weber
Counselor, LMHC
Verified Verified
Dubuque, IA 52001
I believe life is a series of winding paths and enjoy meeting with individuals, families, and couples to navigate these paths so they can work towards a more fulfilling life. My overall style of therapy is eclectic, meaning I enjoy mixing a variety of techniques. Using this therapy strategy, I find I am best able to meet the needs of each individual client. Even so, cognitive-behavioral therapy and client-centered therapy are among my favorite styles. I believe the therapeutic alliance between therapist and client is of extreme importance, so I focus strongly on building this therapeutic connection.
I believe life is a series of winding paths and enjoy meeting with individuals, families, and couples to navigate these paths so they can work towards a more fulfilling life. My overall style of therapy is eclectic, meaning I enjoy mixing a variety of techniques. Using this therapy strategy, I find I am best able to meet the needs of each individual client. Even so, cognitive-behavioral therapy and client-centered therapy are among my favorite styles. I believe the therapeutic alliance between therapist and client is of extreme importance, so I focus strongly on building this therapeutic connection.
(563) 362-3012 x3 View (563) 362-3012 x3
Photo of Bailey Callahan, MA, t-LMHC, Counselor
Bailey Callahan
Counselor, MA, t-LMHC
Verified Verified
1 Endorsed
Dubuque, IA 52003
Taking new clients. I have worked with clients experiencing various mental health struggles, including depression, anxiety, trauma, and life changes. I use an empathetic, person-centered approach, which allows us to build a therapeutic relationship rooted in trust and acceptance.
Taking new clients. I have worked with clients experiencing various mental health struggles, including depression, anxiety, trauma, and life changes. I use an empathetic, person-centered approach, which allows us to build a therapeutic relationship rooted in trust and acceptance.
(563) 278-2825 View (563) 278-2825
Photo of Claire Hunt, MSW, LISW, Clinical Social Work/Therapist
Claire Hunt
Clinical Social Work/Therapist, MSW, LISW
Verified Verified
Dubuque, IA 52001
I will collaborate with you to address what you're facing in a way that works for you whether it be in mental health, interpersonal relationships or other issues you are facing past or present. We are shaped by our unique life circumstances and experiences and I will take this into account as we work together.
I will collaborate with you to address what you're facing in a way that works for you whether it be in mental health, interpersonal relationships or other issues you are facing past or present. We are shaped by our unique life circumstances and experiences and I will take this into account as we work together.
(563) 275-6445 View (563) 275-6445
1

How does your Therapist compare?

Number of Therapists in Dubuque, IA

90+

Average cost per session

$157

Therapists in Dubuque, IA who prioritize treating:

95% Anxiety
89% Depression
81% Coping Skills
76% Self Esteem
75% Stress
71% Trauma and PTSD
70% Relationship Issues

Average years in practice

9 Years

Top 3 insurances accepted

84% BlueCross and BlueShield
71% UnitedHealthcare UHC | UBH
57% Wellmark BCBS

How Therapists in Dubuque, IA see their clients

82% In Person and Online
18% Online Only

Gender breakdown

83% Female
15% Male
2% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Dubuque?

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.