Therapists in Fairfax, VA

Photo of Nina Rosenberg, Clinical Social Work/Therapist in Fairfax, VA
Nina Rosenberg
Clinical Social Work/Therapist, LCSW, LICSW
Verified Verified
Fairfax, VA 22030
Therapy provides a safe space for you to share your story, connect to your inner world & nurture yourself in order to promote healing and growth. Through the use of traditional talk therapy, body based work, mindfulness, & expressive modalities my hope is for clients to walk away feeling seen, heard, & empowered to face challenges that are prevalent in their lives. My intention is to create a therapeutic alliance rooted in compassion, kindness, and empathy in order for clients to embody their truest self.
Therapy provides a safe space for you to share your story, connect to your inner world & nurture yourself in order to promote healing and growth. Through the use of traditional talk therapy, body based work, mindfulness, & expressive modalities my hope is for clients to walk away feeling seen, heard, & empowered to face challenges that are prevalent in their lives. My intention is to create a therapeutic alliance rooted in compassion, kindness, and empathy in order for clients to embody their truest self.
(571) 520-4964 View (571) 520-4964
Photo of Marc Patrick Davis, Supervisee in Clinical Social Work in Fairfax, VA
Marc Patrick Davis
Supervisee in Clinical Social Work, MSW, MT-BC, LMHP-S
Verified Verified
Fairfax, VA 22033  (Online Only)
Accepting new Telehealth clients! When looking for a therapist, it is critical that we find someone with whom we can be our authentic selves, in an atmosphere without judgement or bias. Marc Davis (he/him) is a Licensed Mental Health Professional-Supervisee in Social Work (LMHP-S), and has received board approval to provide clinical services in social work under supervision. He is a Board Certified Music Therapist (MT-BC) and has been practicing professionally for over 12 years. Marc has a bachelor’s degree in music therapy from Berklee College of Music and master’s degree in social work from George Mason University.
Accepting new Telehealth clients! When looking for a therapist, it is critical that we find someone with whom we can be our authentic selves, in an atmosphere without judgement or bias. Marc Davis (he/him) is a Licensed Mental Health Professional-Supervisee in Social Work (LMHP-S), and has received board approval to provide clinical services in social work under supervision. He is a Board Certified Music Therapist (MT-BC) and has been practicing professionally for over 12 years. Marc has a bachelor’s degree in music therapy from Berklee College of Music and master’s degree in social work from George Mason University.
(703) 952-1948 View (703) 952-1948
Photo of Tamar Ares, Licensed Professional Counselor in Fairfax, VA
Tamar Ares
Licensed Professional Counselor, MA, LPC
Verified Verified
Fairfax, VA 22030  (Online Only)
As a therapist I support client’s growth and unfolding, connection to self, and empowerment. I specialize in working with clients dealing with a history of complex trauma, anxiety, depression, relationship and intimacy issues, a search for more meaning, and I have an interest in facilitating a more loving relationship within self and between people in relationship. I see clients for both short-term therapy and long-term therapy depending on what clients goals are and see clients anywhere from once per week to several times per week.
As a therapist I support client’s growth and unfolding, connection to self, and empowerment. I specialize in working with clients dealing with a history of complex trauma, anxiety, depression, relationship and intimacy issues, a search for more meaning, and I have an interest in facilitating a more loving relationship within self and between people in relationship. I see clients for both short-term therapy and long-term therapy depending on what clients goals are and see clients anywhere from once per week to several times per week.
(703) 782-8662 View (703) 782-8662
Photo of Jeanmarie O'Sullivan in Fairfax, VA
Jeanmarie O'Sullivan
LCSW
Verified Verified
1 Endorsed
Fairfax, VA 22030  (Online Only)
I enjoy working adolescents and adults who are struggling with ADHD, anxiety, depression, trauma, and stress. Individuals often reach out to therapists when life has presented them with significant challenges, I approach all patients with a goal-oriented style by developing an action plan to work through these challenges. My goal is to meet each client where they are in life and provide you skills and techniques to help you live a meaningful life.
I enjoy working adolescents and adults who are struggling with ADHD, anxiety, depression, trauma, and stress. Individuals often reach out to therapists when life has presented them with significant challenges, I approach all patients with a goal-oriented style by developing an action plan to work through these challenges. My goal is to meet each client where they are in life and provide you skills and techniques to help you live a meaningful life.
(571) 200-4524 View (571) 200-4524
Photo of Katherine Hannon, Counselor in Fairfax, VA
Katherine Hannon
Counselor, LCPC, MA, NCC, BCC
Verified Verified
1 Endorsed
Fairfax, VA 22031
Not accepting new clients
Finding a therapist who is a great match for you is essential to counseling, to helping you move forward with your life and relationships. Whether online or In my calm and comfortable office in Virginia, I help individuals learn tools to repair their relationships and counsel adults for depression, anxiety and grief. I provide a warm, non-judgmental setting to help you grow. We will work together as a team as I teach you how to use tools enhance your relationships; enrich your sense of self; cope and heal from loss; and manage symptoms of depression and anxiety. All sessions are for individual counseling, not for couples.
Finding a therapist who is a great match for you is essential to counseling, to helping you move forward with your life and relationships. Whether online or In my calm and comfortable office in Virginia, I help individuals learn tools to repair their relationships and counsel adults for depression, anxiety and grief. I provide a warm, non-judgmental setting to help you grow. We will work together as a team as I teach you how to use tools enhance your relationships; enrich your sense of self; cope and heal from loss; and manage symptoms of depression and anxiety. All sessions are for individual counseling, not for couples.
(703) 546-9576 View (703) 546-9576
Photo of Char Bentley, Clinical Social Work/Therapist in Fairfax, VA
Char Bentley
Clinical Social Work/Therapist, LCSW
Verified Verified
Fairfax, VA 22030  (Online Only)
If you’re looking for help navigating life struggles, finding effective tools to better regulate your emotions, or need additional guidance on creating a full, thriving life then
If you’re looking for help navigating life struggles, finding effective tools to better regulate your emotions, or need additional guidance on creating a full, thriving life then
(571) 200-3284 View (571) 200-3284
Photo of Elizabeth M. Nielsen, LPC Intern in Fairfax, VA
Elizabeth M. Nielsen
LPC Intern, MAT
Verified Verified
1 Endorsed
Fairfax, VA 22030
In life, we all experience times of change and uncertainty. It is common to question our decisions and feel lost as we search for our purpose. This can lead to feelings of stress, anxiety, grief, and loss. I am committed to helping military service members, Veterans, and their families through the transitions of life. Using a compassionate and evidence-based approach, I provide support to individuals aged six and up who are facing grief, loss, and other challenges.
In life, we all experience times of change and uncertainty. It is common to question our decisions and feel lost as we search for our purpose. This can lead to feelings of stress, anxiety, grief, and loss. I am committed to helping military service members, Veterans, and their families through the transitions of life. Using a compassionate and evidence-based approach, I provide support to individuals aged six and up who are facing grief, loss, and other challenges.
(571) 901-1917 View (571) 901-1917
Photo of Dr. Mwende K. Mualuko, Psychologist in Fairfax, VA
Dr. Mwende K. Mualuko
Psychologist, PhD
Verified Verified
2 Endorsed
Fairfax, VA 22031
I am a Licensed Clinical Psychologist offering evidence-based trauma therapies including Prolonged Exposure, Cognitive Processing Therapy and Trauma Focused CBT. Many of my patients are active duty, veteran and federally employed (civilian). I learned to treat emotional trauma by working with PTSD field experts at the Departments of Defense and Veterans Affairs. These treatments are gold-standard PTSD interventions endorsed by the American Psychological Association and National Center for PTSD.
I am a Licensed Clinical Psychologist offering evidence-based trauma therapies including Prolonged Exposure, Cognitive Processing Therapy and Trauma Focused CBT. Many of my patients are active duty, veteran and federally employed (civilian). I learned to treat emotional trauma by working with PTSD field experts at the Departments of Defense and Veterans Affairs. These treatments are gold-standard PTSD interventions endorsed by the American Psychological Association and National Center for PTSD.
(703) 634-4490 View (703) 634-4490
Photo of Jennifer Parrella - Decoding Relationships, LLC, Licensed Professional Counselor in Fairfax, VA
Jennifer Parrella - Decoding Relationships, LLC
Licensed Professional Counselor, MS, LPC, LCMHC, NCC, CCTP
Verified Verified
Fairfax, VA 22030  (Online Only)
I believe individuals, couples, & families can adjust their thinking, behaviors, & patterns to improve their lives and relationships. My approach is compassionate yet honest & straightforward. I teach healthy patterns to replace negative ones. I take a pro-relationship, trauma informed, approach to all relationships, helping people and their loved ones make changes in order to feel closer and happier together. Feel free to reach out via email or phone at any time w/ questions or to schedule an appt. I am accepting new clients and offer day & evening virtual hours M-F. Sessions & paperwork are facilitated via confidential web-portal.
I believe individuals, couples, & families can adjust their thinking, behaviors, & patterns to improve their lives and relationships. My approach is compassionate yet honest & straightforward. I teach healthy patterns to replace negative ones. I take a pro-relationship, trauma informed, approach to all relationships, helping people and their loved ones make changes in order to feel closer and happier together. Feel free to reach out via email or phone at any time w/ questions or to schedule an appt. I am accepting new clients and offer day & evening virtual hours M-F. Sessions & paperwork are facilitated via confidential web-portal.
(703) 936-6326 View (703) 936-6326
Photo of RCCS, LLC, Clinical Social Work/Therapist in Fairfax, VA
RCCS, LLC
Clinical Social Work/Therapist, LCSW , MSSW, MFT
Verified Verified
4 Endorsed
Fairfax, VA 22030  (Online Only)
Currently seeing clients via Telehealth only. I have worked with clients with a wide range of concerns including depression, anxiety, relationship issues, parenting problems, career challenges, and substance abuse related issues. I also helped many people who have experienced physical trauma or emotional abuse. My goal in life is to assist any person/s in need of recovery or growth. I focus on inner strength and self exploration by providing counseling services to individuals, couples and families.
Currently seeing clients via Telehealth only. I have worked with clients with a wide range of concerns including depression, anxiety, relationship issues, parenting problems, career challenges, and substance abuse related issues. I also helped many people who have experienced physical trauma or emotional abuse. My goal in life is to assist any person/s in need of recovery or growth. I focus on inner strength and self exploration by providing counseling services to individuals, couples and families.
(540) 600-4620 View (540) 600-4620
Photo of Andrea Levy, Clinical Social Work/Therapist in Fairfax, VA
Andrea Levy
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
5 Endorsed
Fairfax, VA 22030
Waitlist for new clients
I am a Licensed Clinical Social Worker and have been working in the mental health field for over 20 years. I view therapy as a collaborative process that enables clients to gain perspective on their emotions, beliefs, relationships and behaviors. My approach is empathic, authentic and warm. I work from a strengths based perspective and assist clients in facing life challenges in realistic ways through a combination of cognitive behavioral and psychodynamic therapies. I provide a confidential, safe environment for exploration and change.
I am a Licensed Clinical Social Worker and have been working in the mental health field for over 20 years. I view therapy as a collaborative process that enables clients to gain perspective on their emotions, beliefs, relationships and behaviors. My approach is empathic, authentic and warm. I work from a strengths based perspective and assist clients in facing life challenges in realistic ways through a combination of cognitive behavioral and psychodynamic therapies. I provide a confidential, safe environment for exploration and change.
(703) 634-4782 View (703) 634-4782
Photo of Tara L Reynolds, Psychologist in Fairfax, VA
Tara L Reynolds
Psychologist, PsyD
Verified Verified
7 Endorsed
Fairfax, VA 22030
Do you find yourself feeling sad or anxious for no particular reason? Do you sometimes wish you had help managing life and all of its challenges? I can help you by providing a compassionate, safe, and non-judgemental place to express your deepest thoughts and feelings and explore options to resolve the problems you are facing.
Do you find yourself feeling sad or anxious for no particular reason? Do you sometimes wish you had help managing life and all of its challenges? I can help you by providing a compassionate, safe, and non-judgemental place to express your deepest thoughts and feelings and explore options to resolve the problems you are facing.
(703) 810-7706 View (703) 810-7706
Photo of Kathy M Stevens, Licensed Professional Counselor in Fairfax, VA
Kathy M Stevens
Licensed Professional Counselor, MA, LPC
Verified Verified
Fairfax, VA 22030  (Online Only)
Waitlist for new clients
I have provided counseling services in a variety of environments, including community Mental Health, hospital, and home-based family service. I currently serve preschool through middle school age children who experience adjustment issues, anxiety, depression, learning disabilities, or developmental delays. Utilizing play therapy and experiential therapy with the children, I also encourage family participation in the counseling process. I serve couples and individuals as well. If you need assistance with relationship issues, dealing with depression or anxiety, or simply need a safe, nurturing environment to sort out the stresses of life, please call or send me an email.
I have provided counseling services in a variety of environments, including community Mental Health, hospital, and home-based family service. I currently serve preschool through middle school age children who experience adjustment issues, anxiety, depression, learning disabilities, or developmental delays. Utilizing play therapy and experiential therapy with the children, I also encourage family participation in the counseling process. I serve couples and individuals as well. If you need assistance with relationship issues, dealing with depression or anxiety, or simply need a safe, nurturing environment to sort out the stresses of life, please call or send me an email.
(703) 457-9303 View (703) 457-9303
Photo of Megan Elizabeth Fellows, Licensed Professional Counselor in Fairfax, VA
Megan Elizabeth Fellows
Licensed Professional Counselor, MA, LPC
Verified Verified
4 Endorsed
Fairfax, VA 22030
Waitlist for new clients
As a Licensed Professional Counselor with over years experience in the mental health field, I thoroughly enjoy my role in helping others to reach their goals. I have worked with individuals, families, and groups in both inpatient and outpatient settings within the DC Metro area. Specifically, I have experience with adults, adolescents, and children presenting with a variety of concerns and needs. I have also had the privilege of serving individuals with intellectual disabilities and developmental delays in both private, in-home, and educational settings.
As a Licensed Professional Counselor with over years experience in the mental health field, I thoroughly enjoy my role in helping others to reach their goals. I have worked with individuals, families, and groups in both inpatient and outpatient settings within the DC Metro area. Specifically, I have experience with adults, adolescents, and children presenting with a variety of concerns and needs. I have also had the privilege of serving individuals with intellectual disabilities and developmental delays in both private, in-home, and educational settings.
(571) 374-1726 View (571) 374-1726
Photo of Joseph Autry, Licensed Professional Counselor in Fairfax, VA
Joseph Autry
Licensed Professional Counselor, LPC
Verified Verified
Fairfax, VA 22033
Nice to meet you! My name is Joseph Autry and I am a Licensed Professional Counselor with over 8 years of experience. I have worked with clients with anxiety, depression, substance use, personality, mood regulation, suicidal thoughts, self-harm, PTSD, eating disorders, and problems with trauma. I will often use a combination of Cognitive Behavioral Therapy and Dialectical Behavioral Therapy. Motivational Interviewing and Solution Focused Therapy are forms of therapy I usually like to use as well. I believe that being a therapist has allowed me to work and help clients who are feeling depressed and having thoughts of wanting to hurt
Nice to meet you! My name is Joseph Autry and I am a Licensed Professional Counselor with over 8 years of experience. I have worked with clients with anxiety, depression, substance use, personality, mood regulation, suicidal thoughts, self-harm, PTSD, eating disorders, and problems with trauma. I will often use a combination of Cognitive Behavioral Therapy and Dialectical Behavioral Therapy. Motivational Interviewing and Solution Focused Therapy are forms of therapy I usually like to use as well. I believe that being a therapist has allowed me to work and help clients who are feeling depressed and having thoughts of wanting to hurt
(571) 554-5377 View (571) 554-5377
Photo of Alexis Melville (She Her), Psychologist in Fairfax, VA
Alexis Melville (She Her)
Psychologist, PsyD
Verified Verified
1 Endorsed
Fairfax, VA 22033  (Online Only)
You feel exhausted wearing multiple masks, being “too much” for some people in your life and “not enough” for others. You feel proud of what you have achieved but immediately guilty because you don’t want to come off as “full of yourself.” You get annoyed at the question “where are you from?” because the answer is complicated and it reminds you of the difficulty you are having coping with discrimination and other 'isms that are part of this new country. Everyone thinks that you "got it all together" even though you question how you fit into expectations from your parents and society. You are tired of hiding who you really are.
You feel exhausted wearing multiple masks, being “too much” for some people in your life and “not enough” for others. You feel proud of what you have achieved but immediately guilty because you don’t want to come off as “full of yourself.” You get annoyed at the question “where are you from?” because the answer is complicated and it reminds you of the difficulty you are having coping with discrimination and other 'isms that are part of this new country. Everyone thinks that you "got it all together" even though you question how you fit into expectations from your parents and society. You are tired of hiding who you really are.
(703) 687-0083 View (703) 687-0083
Photo of Ann Inouye, Psychologist in Fairfax, VA
Ann Inouye
Psychologist, PsyD
Verified Verified
Fairfax, VA 22030  (Online Only)
Aloha! Life brings its challenges, and if you're seeking a safe and empathetic space to navigate your emotions and thoughts, I'd be honored to join you on this journey. Together, we will collaborate towards building a meaningful life that is aligned with your values. Through my training at both Yale and Brown, and internship at a renowned PTSD research center, you can be assured that my services incorporate the latest advances in our understanding of our common humanity.
Aloha! Life brings its challenges, and if you're seeking a safe and empathetic space to navigate your emotions and thoughts, I'd be honored to join you on this journey. Together, we will collaborate towards building a meaningful life that is aligned with your values. Through my training at both Yale and Brown, and internship at a renowned PTSD research center, you can be assured that my services incorporate the latest advances in our understanding of our common humanity.
(571) 202-6200 View (571) 202-6200
Photo of Shonna Pope, Clinical Social Work/Therapist in Fairfax, VA
Shonna Pope
Clinical Social Work/Therapist, LCSW
Verified Verified
3 Endorsed
Fairfax, VA 22030  (Online Only)
Not accepting new clients
Are you tired and overwhelmed with a situation in your life? Do you wake up in the mornings wondering how you got to this place? Sometimes we get stuck in life and can't find our way out or don't know how to create change. Whether you're struggling with a relationship issue, a divorce, remarriage with step children, a loss, a work issue or simply wanting to learn more about yourself, I will join you on your journey to feeling more content and happier in your life.
Are you tired and overwhelmed with a situation in your life? Do you wake up in the mornings wondering how you got to this place? Sometimes we get stuck in life and can't find our way out or don't know how to create change. Whether you're struggling with a relationship issue, a divorce, remarriage with step children, a loss, a work issue or simply wanting to learn more about yourself, I will join you on your journey to feeling more content and happier in your life.
(703) 468-8359 View (703) 468-8359
Photo of Dr. Laura Russell, Psychologist in Fairfax, VA
Dr. Laura Russell
Psychologist, PsyD
Verified Verified
1 Endorsed
Fairfax, VA 22030
Are you feeling emotionally depleted or fearfully uncertain about the future? I offer therapy for individuals who are struggling with anxiety, depression, grief/loss, relationship issues, OCD, insomnia, trauma, chronic pain, and ADHD. If you are feeling distressed, isolated, or experiencing problems in your relationships I hope I can guide you through these challenging times. My goal as your therapist would be to help you find your own pathway to healing, balance, and a peace of mind.
Are you feeling emotionally depleted or fearfully uncertain about the future? I offer therapy for individuals who are struggling with anxiety, depression, grief/loss, relationship issues, OCD, insomnia, trauma, chronic pain, and ADHD. If you are feeling distressed, isolated, or experiencing problems in your relationships I hope I can guide you through these challenging times. My goal as your therapist would be to help you find your own pathway to healing, balance, and a peace of mind.
(571) 526-0449 View (571) 526-0449
Photo of Michael M. Fahmy, Resident in Counseling in Fairfax, VA
Michael M. Fahmy
Resident in Counseling, MA
Verified Verified
8 Endorsed
Fairfax, VA 22030
Dealing with significant losses, feeling trapped, or uncertain about handling emotions? Adjusting to changes can be difficult; life's trials may bring exhaustion and stress. With training in EMDR therapy, I am here to guide you through these times.
Dealing with significant losses, feeling trapped, or uncertain about handling emotions? Adjusting to changes can be difficult; life's trials may bring exhaustion and stress. With training in EMDR therapy, I am here to guide you through these times.
(571) 946-6098 View (571) 946-6098

How does your Therapist compare?

Number of Therapists in Fairfax, VA

1,000+

Average cost per session

$150

Therapists in Fairfax, VA who prioritize treating:

93% Anxiety
88% Depression
78% Self Esteem
73% Coping Skills
71% Relationship Issues
67% Trauma and PTSD
62% Stress

Average years in practice

12 Years

Top 3 insurances accepted

74% BlueCross and BlueShield
64% Cigna and Evernorth
58% UnitedHealthcare UHC | UBH

How Therapists in Fairfax, VA see their clients

58% In Person and Online
42% Online Only

Gender breakdown

84% Female
15% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Fairfax?

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.