Therapists in Hiawatha, IA

Photo of Caroline Gimarc, Pre-Licensed Professional, PhD, tLMFT
Caroline Gimarc
Pre-Licensed Professional, PhD, tLMFT
1 Endorsed
Hiawatha, IA 52233
I have immediate openings on Tuesdays and Fridays. I look forward to hearing about how I can support you. There are times in life where you may find yourself struggling and needing extra support. Major life transitions can cause stress in life and a need to understand who you are. I offer a space for you to explore the difficulties that you are facing and become more confident in who you are. We will look at what is holding you back as well as work through what might be standing in the way of you becoming your best self.
I have immediate openings on Tuesdays and Fridays. I look forward to hearing about how I can support you. There are times in life where you may find yourself struggling and needing extra support. Major life transitions can cause stress in life and a need to understand who you are. I offer a space for you to explore the difficulties that you are facing and become more confident in who you are. We will look at what is holding you back as well as work through what might be standing in the way of you becoming your best self.
(319) 284-4211 View (319) 284-4211
Photo of Delaney Logan, Counselor, LMHC
Delaney Logan
Counselor, LMHC
3 Endorsed
Hiawatha, IA 52233
I work primarily with adults, though I also enjoy working with teens aged 13 and up. My areas of focus include depression, anxiety, trauma, life transitions, LGBTQ+ concerns, body image, and interpersonal challenges. I am now offering Eye Movement Desensitization and Reprocessing (EMDR) services. My approach is collaborative and individualized—there’s no one-size-fits-all in therapy. I aim to help clients improve their overall well-being by finding what works best for them. Whether you're looking to process past experiences, build healthier relationships, or navigate life changes, I offer a supportive space to explore and grow.
I work primarily with adults, though I also enjoy working with teens aged 13 and up. My areas of focus include depression, anxiety, trauma, life transitions, LGBTQ+ concerns, body image, and interpersonal challenges. I am now offering Eye Movement Desensitization and Reprocessing (EMDR) services. My approach is collaborative and individualized—there’s no one-size-fits-all in therapy. I aim to help clients improve their overall well-being by finding what works best for them. Whether you're looking to process past experiences, build healthier relationships, or navigate life changes, I offer a supportive space to explore and grow.
(319) 264-1573 View (319) 264-1573
Photo of Tiara Munoz, Pre-Licensed Professional, tLMFT
Tiara Munoz
Pre-Licensed Professional, tLMFT
4 Endorsed
Hiawatha, IA 52233
As an experiential therapist, I am dedicated to creating safe and brave spaces where individuals, couples, and families can authentically connect with their emotions. My approach centers on the belief that healing happens through direct emotional experience and expression. By fostering trust, curiosity, and compassion, I support clients in exploring their inner worlds, deepening relationships, and finding new ways of being. Whether working through past trauma, navigating conflict, or building emotional resilience, I guide clients with presence and care as they reclaim their voices and create meaningful change.
As an experiential therapist, I am dedicated to creating safe and brave spaces where individuals, couples, and families can authentically connect with their emotions. My approach centers on the belief that healing happens through direct emotional experience and expression. By fostering trust, curiosity, and compassion, I support clients in exploring their inner worlds, deepening relationships, and finding new ways of being. Whether working through past trauma, navigating conflict, or building emotional resilience, I guide clients with presence and care as they reclaim their voices and create meaningful change.
(319) 671-6353 View (319) 671-6353
Photo of Jason Cleveland, Marriage & Family Therapist, MA, LMFT
Jason Cleveland
Marriage & Family Therapist, MA, LMFT
1 Endorsed
Hiawatha, IA 52233
Usually when someone asks me why they should go to therapy, I ask them if they think they could benefit from having a non-judgmental third party whose only motive in therapy is to help them get what they want in life. Having someone who can help identify the obstacles and then walk beside you to find healing and the solutions to the presenting struggles can be life changing. I want to be that person for you. The safe soul Sherpa. To be for you at times a guide, to be someone you can feel safe with, to feel safe enough to feel and heal, to be someone to challenge you to grow and find the light that is always shining within you.
Usually when someone asks me why they should go to therapy, I ask them if they think they could benefit from having a non-judgmental third party whose only motive in therapy is to help them get what they want in life. Having someone who can help identify the obstacles and then walk beside you to find healing and the solutions to the presenting struggles can be life changing. I want to be that person for you. The safe soul Sherpa. To be for you at times a guide, to be someone you can feel safe with, to feel safe enough to feel and heal, to be someone to challenge you to grow and find the light that is always shining within you.
(319) 419-4891 View (319) 419-4891
Photo of Ashley Kullmer, Marriage & Family Therapist, MA, tLMFT
Ashley Kullmer
Marriage & Family Therapist, MA, tLMFT
4 Endorsed
Hiawatha, IA 52233
Therapy can be serious, playful, heavy, and full of laughs and light—all in the same hour. I work with people navigating life transitions, relationship stress, identity questions, grief, and healing from religious or cultural harm. Many of my clients are LGBTQ+ folks, neurodivergent individuals, couples wanting to reconnect, families learning to communicate, or kids struggling to express big feelings. I offer space to explore what matters most, together.
Therapy can be serious, playful, heavy, and full of laughs and light—all in the same hour. I work with people navigating life transitions, relationship stress, identity questions, grief, and healing from religious or cultural harm. Many of my clients are LGBTQ+ folks, neurodivergent individuals, couples wanting to reconnect, families learning to communicate, or kids struggling to express big feelings. I offer space to explore what matters most, together.
(319) 601-8059 View (319) 601-8059
Photo of Kim Korte, Counselor, MA, LMHC
Kim Korte
Counselor, MA, LMHC
Hiawatha, IA 52233
Hello. I'm a licensed mental health counselor that has been in practice since 2000. I help clients who are dealing with trauma, abuse, grief, anxiety, depression, behavior and school problems. I enjoy helping my clients work through traumatic events, losses and stressful circumstances. I also enjoy helping clients learn more effective ways of thinking and behaving, helping them create healthier relationships and life choices and to see them feel better about themselves.
Hello. I'm a licensed mental health counselor that has been in practice since 2000. I help clients who are dealing with trauma, abuse, grief, anxiety, depression, behavior and school problems. I enjoy helping my clients work through traumatic events, losses and stressful circumstances. I also enjoy helping clients learn more effective ways of thinking and behaving, helping them create healthier relationships and life choices and to see them feel better about themselves.
(319) 878-6255 View (319) 878-6255
Photo of Darren Kirk, Clinical Social Work/Therapist, LISW
Darren Kirk
Clinical Social Work/Therapist, LISW
Hiawatha, IA 52233
Life can feel overwhelming at times but healing and growth are always possible. With 14 years of experience, I am dedicated to helping adolescents, teens, college students, and parents navigate life’s challenges with care and understanding. Using a trauma-informed approach that integrates CBT (Cognitive Behavioral Therapy), ACT (Acceptance & Commitment Therapy), and TBRI (Trust Based Relational Intervention), I support individuals and families working through trauma, anxiety, depression, grief, and impulsivity—fostering resilience and lasting well-being.
Life can feel overwhelming at times but healing and growth are always possible. With 14 years of experience, I am dedicated to helping adolescents, teens, college students, and parents navigate life’s challenges with care and understanding. Using a trauma-informed approach that integrates CBT (Cognitive Behavioral Therapy), ACT (Acceptance & Commitment Therapy), and TBRI (Trust Based Relational Intervention), I support individuals and families working through trauma, anxiety, depression, grief, and impulsivity—fostering resilience and lasting well-being.
(319) 253-8478 View (319) 253-8478
Photo of Heidi Powers, Counselor, LMHC
Heidi Powers
Counselor, LMHC
7 Endorsed
Hiawatha, IA 52233
Waitlist for new clients
Do you have increasing concerns about your child’s mood and behavior? Perhaps your child has experienced a change, loss, traumatic experience or is struggling with peer relationships. As a parent, when your child is hurting, you hurt with them. While it can be difficult to ask for help, you don’t have to face these struggles alone. Many children experience mental and behavioral health challenges that are treatable. Through therapy, your child can develop healthy coping tools, improve emotional regulation, and learn positive and appropriate ways to get their needs met.
Do you have increasing concerns about your child’s mood and behavior? Perhaps your child has experienced a change, loss, traumatic experience or is struggling with peer relationships. As a parent, when your child is hurting, you hurt with them. While it can be difficult to ask for help, you don’t have to face these struggles alone. Many children experience mental and behavioral health challenges that are treatable. Through therapy, your child can develop healthy coping tools, improve emotional regulation, and learn positive and appropriate ways to get their needs met.
(319) 900-1840 View (319) 900-1840
Photo of Jaylen McBride, Marriage & Family Therapist, MA, tLMFT
Jaylen McBride
Marriage & Family Therapist, MA, tLMFT
5 Endorsed
Hiawatha, IA 52233
It can be challenging to determine when or where to begin your therapeutic journey. I understand firsthand the courage it takes to ask for help and the weight of stigma that can make those first steps feel even heavier. When we take an active role in our lives and well-being, we can reclaim our inherent creativity, resilience, and curiosity, qualities that allow us to navigate life’s challenges with openness and authenticity. Whether it is your first time or you have been on this journey for some time, I hope to create a space where you can start exploring new possibilities for yourself and relationships.
It can be challenging to determine when or where to begin your therapeutic journey. I understand firsthand the courage it takes to ask for help and the weight of stigma that can make those first steps feel even heavier. When we take an active role in our lives and well-being, we can reclaim our inherent creativity, resilience, and curiosity, qualities that allow us to navigate life’s challenges with openness and authenticity. Whether it is your first time or you have been on this journey for some time, I hope to create a space where you can start exploring new possibilities for yourself and relationships.
(319) 258-5971 View (319) 258-5971
Photo of Erin Forbes, Clinical Social Work/Therapist, MSW, LISW
Erin Forbes
Clinical Social Work/Therapist, MSW, LISW
9 Endorsed
Hiawatha, IA 52233
As a therapist, I believe that a person is more than just the sum of their experiences. Each one of us is made up of our unique thoughts, emotions and ideas. I have devoted my career to finding ways of honoring who you are, as well as who you want to become. My clients range from children to adults, and my special interests are with teens, parents and families. I am clinically trained to help individuals and families experiencing trauma, anxiety, depression, impulsivity, conflicts and grief. My style is direct, non-judgmental and supportive, as we work together to create a treatment plan that uniquely fits your needs.
As a therapist, I believe that a person is more than just the sum of their experiences. Each one of us is made up of our unique thoughts, emotions and ideas. I have devoted my career to finding ways of honoring who you are, as well as who you want to become. My clients range from children to adults, and my special interests are with teens, parents and families. I am clinically trained to help individuals and families experiencing trauma, anxiety, depression, impulsivity, conflicts and grief. My style is direct, non-judgmental and supportive, as we work together to create a treatment plan that uniquely fits your needs.
(319) 670-3545 View (319) 670-3545
Photo of Madison Miller, Marriage & Family Therapist, LMFT
Madison Miller
Marriage & Family Therapist, LMFT
1 Endorsed
Hiawatha, IA 52233
Waitlist for new clients
Everyone deserves compassion and love, as well as a place to feel safe and supported. I take a collaborative approach in working with clients to discover their true potential and reach their desired goals. I strive to provide each person with a nonjudgmental and safe place for emotional expression, exploration of perspective, and finding personal understanding and acceptance. I truly believe that every person is capable of growth and improvement, whatever that may look like for their personal journey.
Everyone deserves compassion and love, as well as a place to feel safe and supported. I take a collaborative approach in working with clients to discover their true potential and reach their desired goals. I strive to provide each person with a nonjudgmental and safe place for emotional expression, exploration of perspective, and finding personal understanding and acceptance. I truly believe that every person is capable of growth and improvement, whatever that may look like for their personal journey.
(319) 729-8220 View (319) 729-8220
Photo of Echo Kent, Marriage & Family Therapist, MA, LMFT
Echo Kent
Marriage & Family Therapist, MA, LMFT
1 Endorsed
Hiawatha, IA 52233
I believe everyone deserves the chance to move from distress toward a more balanced and fulfilling life. I work with people navigating trauma, challenges with body image and self-esteem, or difficulties in relationships. For couples, I integrate Intimacy from the Inside Out (IFIO), an IFS-based approach that supports deeper connection and healing in relationships. Together, we’ll focus on easing negative feelings, building healthier coping skills, and strengthening the bonds that matter most to you. My therapeutic style is supportive and respectful, while also goal-oriented and practical. Treatment is tailored to each client.
I believe everyone deserves the chance to move from distress toward a more balanced and fulfilling life. I work with people navigating trauma, challenges with body image and self-esteem, or difficulties in relationships. For couples, I integrate Intimacy from the Inside Out (IFIO), an IFS-based approach that supports deeper connection and healing in relationships. Together, we’ll focus on easing negative feelings, building healthier coping skills, and strengthening the bonds that matter most to you. My therapeutic style is supportive and respectful, while also goal-oriented and practical. Treatment is tailored to each client.
(319) 409-6773 View (319) 409-6773
Photo of Jennifer VansCoy, Counselor, LMHC
Jennifer VansCoy
Counselor, LMHC
4 Endorsed
Hiawatha, IA 52233
Are you here because life is feeling overwhelming, but you keep telling yourself it's “It's fine, I'm fine, it's ALL fine”, even though you know it’s not? Maybe your depression or anxiety is up, or big events have shaken up your life. Now you’re looking for a space where you’ll feel comfortable and safe so that you can be free to express yourself. Maybe you’re not even sure how to do that. You just know that you need to do something. Therapy can be that something and can help you move your life in the direction that you want it to go (even if you don't know what direction that is right now!).
Are you here because life is feeling overwhelming, but you keep telling yourself it's “It's fine, I'm fine, it's ALL fine”, even though you know it’s not? Maybe your depression or anxiety is up, or big events have shaken up your life. Now you’re looking for a space where you’ll feel comfortable and safe so that you can be free to express yourself. Maybe you’re not even sure how to do that. You just know that you need to do something. Therapy can be that something and can help you move your life in the direction that you want it to go (even if you don't know what direction that is right now!).
(319) 313-2668 View (319) 313-2668
Photo of Ellie Pereboom, Counselor, LMHC
Ellie Pereboom
Counselor, LMHC
Hiawatha, IA 52233
Everyone is on their own adventure exploring the sea of life and you are your own captain running this ship. Just like ships, our lives need maintenance, our lives need a supportive crew, and our lives need guidance from a lighthouse to direct us out of the storms. Maybe you are feeling defeated of having no control over the storms. Maybe you are lost of how to prevent a storm. Maybe you are in the midst of one right now. You are in the right place for wanting to get the help that you deserve!
Everyone is on their own adventure exploring the sea of life and you are your own captain running this ship. Just like ships, our lives need maintenance, our lives need a supportive crew, and our lives need guidance from a lighthouse to direct us out of the storms. Maybe you are feeling defeated of having no control over the storms. Maybe you are lost of how to prevent a storm. Maybe you are in the midst of one right now. You are in the right place for wanting to get the help that you deserve!
(319) 658-5177 View (319) 658-5177
Photo of Presley Tapken, Pre-Licensed Professional, MA, t-LMHC
Presley Tapken
Pre-Licensed Professional, MA, t-LMHC
1 Endorsed
Hiawatha, IA 52233
Hi there, I’m so glad you’re here! My name is Presley. I welcome adolescents and adults who are seeking treatment for anxiety, OCD, depression, trauma, interpersonal challenges, women’s issues, and LGBTQIA+ issues. I also welcome children as young as 5 years old with challenges relating to difficulty expressing/processing emotions, anxiety, interpersonal challenges, and depression.
Hi there, I’m so glad you’re here! My name is Presley. I welcome adolescents and adults who are seeking treatment for anxiety, OCD, depression, trauma, interpersonal challenges, women’s issues, and LGBTQIA+ issues. I also welcome children as young as 5 years old with challenges relating to difficulty expressing/processing emotions, anxiety, interpersonal challenges, and depression.
(319) 250-1267 View (319) 250-1267
Photo of Mwr Counseling - MWR Counseling, Clinical Social Work/Therapist
MWR Counseling
Clinical Social Work/Therapist
Hiawatha, IA 52233
Your health and well-being are important, and when you make the decision to care for your mental health, MWR is here to partner with you. MWR Counseling provides outpatient mental health counseling to individuals, couples, and families. Our providers specialize in multiple areas, including perinatal mental health, EMDR and somatic trauma treatment, and OCD. When you contact MWR, you will be connected with a therapist who is trained and experienced in providing treatment for your specific needs.
Your health and well-being are important, and when you make the decision to care for your mental health, MWR is here to partner with you. MWR Counseling provides outpatient mental health counseling to individuals, couples, and families. Our providers specialize in multiple areas, including perinatal mental health, EMDR and somatic trauma treatment, and OCD. When you contact MWR, you will be connected with a therapist who is trained and experienced in providing treatment for your specific needs.
(319) 419-4339 View (319) 419-4339
Photo of Catherine Vander Zee, Clinical Social Work/Therapist, MSW, LISW
Catherine Vander Zee
Clinical Social Work/Therapist, MSW, LISW
Hiawatha, IA 52233
I strongly believe in the inherent resilience and potential for growth within every individual. My role as a therapist is to provide guidance, support, and practical tools to help you tap into your strengths and navigate life.
I strongly believe in the inherent resilience and potential for growth within every individual. My role as a therapist is to provide guidance, support, and practical tools to help you tap into your strengths and navigate life.
(319) 657-5194 View (319) 657-5194
Photo of Katie Taylor, Marriage & Family Therapist, LMFT
Katie Taylor
Marriage & Family Therapist, LMFT
1 Endorsed
Hiawatha, IA 52233
I have special interest in supporting clients through the unique challenges of the perinatal period (pregnancy and trying to conceive) and the postpartum phase, including anxiety, mood changes, relationship adjustments, and the overwhelming experience of becoming a parent. My goal is for you to move from feeling overwhelmed or stuck to feeling empowered and intentional about your next steps. Whether you need to process birth trauma, manage new parent anxiety, or redefine your identity during a major shift, we will work together to build resilience and cultivate a life that feels genuinely yours.
I have special interest in supporting clients through the unique challenges of the perinatal period (pregnancy and trying to conceive) and the postpartum phase, including anxiety, mood changes, relationship adjustments, and the overwhelming experience of becoming a parent. My goal is for you to move from feeling overwhelmed or stuck to feeling empowered and intentional about your next steps. Whether you need to process birth trauma, manage new parent anxiety, or redefine your identity during a major shift, we will work together to build resilience and cultivate a life that feels genuinely yours.
(319) 220-3665 View (319) 220-3665
Photo of Shayla Stacey, Pre-Licensed Professional, tLMHC
Shayla Stacey
Pre-Licensed Professional, tLMHC
Hiawatha, IA 52233
Life can feel overwhelming—whether it’s anxiety, depression, neurodivergence, or the daily balancing act of motherhood. I work with teens (14+) and adults to help them find relief, clarity, and a greater sense of calm. As a former high school English teacher and a mom, I bring empathy, humor, and a collaborative approach to therapy. Together, we’ll explore your story, uncover strengths, and build tools to navigate life’s challenges with confidence and compassion.
Life can feel overwhelming—whether it’s anxiety, depression, neurodivergence, or the daily balancing act of motherhood. I work with teens (14+) and adults to help them find relief, clarity, and a greater sense of calm. As a former high school English teacher and a mom, I bring empathy, humor, and a collaborative approach to therapy. Together, we’ll explore your story, uncover strengths, and build tools to navigate life’s challenges with confidence and compassion.
(319) 258-5336 View (319) 258-5336
Photo of Jess Harder, Mental Health Counselor, tLMHC
Jess Harder
Mental Health Counselor, tLMHC
Hiawatha, IA 52233
Mental health challenges can feel isolating and overwhelming, often leading to self-doubt and confusion. My goal is to help reduce the confusion and pain and walk alongside you in your journey to healing. My approach is through a collaborative lens that meets individuals where they are. My therapeutic style is empathetic, non-judgmental, and empowers clients toward their personal goals and well-being. Seeking counseling can be daunting and creating a safe environment is at the core of my approach.
Mental health challenges can feel isolating and overwhelming, often leading to self-doubt and confusion. My goal is to help reduce the confusion and pain and walk alongside you in your journey to healing. My approach is through a collaborative lens that meets individuals where they are. My therapeutic style is empathetic, non-judgmental, and empowers clients toward their personal goals and well-being. Seeking counseling can be daunting and creating a safe environment is at the core of my approach.
(319) 246-8723 View (319) 246-8723

See more therapy options for Hiawatha

How does your Therapist compare?

Number of Therapists in Hiawatha, IA

60+

Average cost per session

$175

Therapists in Hiawatha, IA who prioritize treating:

98% Anxiety
90% Depression
84% Stress
79% Relationship Issues
79% Trauma and PTSD
79% Self Esteem
66% ADHD

Average years in practice

8 Years

Top 3 insurances accepted

93% BlueCross and BlueShield
88% Wellmark BCBS
60% Aetna

How Therapists in Hiawatha, IA see their clients

97% In Person and Online
3% Online Only

Gender breakdown

84% Female
16% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Hiawatha?

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.