Therapists in Washington, DC

View neighborhoods in Washington
Photo of John Loughlin-Presnal, Psychologist in Washington, DC
John Loughlin-Presnal
Psychologist, PhD
Verified Verified
1 Endorsed
Washington, DC 20057
As a therapist, I strive to create a space that feels comfortable for you to talk about your unique journey towards greater wellbeing. I approach therapy with a belief that many of our areas of struggle often have roots in our natural adaptations to difficult circumstances. By being curious about the connections between current difficulties and past experiences, we can increase awareness and reflection, which can lead to important shifts in how we function in our lives.
As a therapist, I strive to create a space that feels comfortable for you to talk about your unique journey towards greater wellbeing. I approach therapy with a belief that many of our areas of struggle often have roots in our natural adaptations to difficult circumstances. By being curious about the connections between current difficulties and past experiences, we can increase awareness and reflection, which can lead to important shifts in how we function in our lives.
(814) 247-0983 View (814) 247-0983
Photo of Barbara J Suter, Psychologist in Washington, DC
Barbara J Suter
Psychologist, PhD
Verified Verified
1 Endorsed
Washington, DC 20015
First we together bring rapid relief from your current upsets (e.g., anxiety, depression), before moving on to any deeper issues. We work together directly, actively, and with care, focusing on mutually agreed upon goals. Together we work emphasizing strengths as well as dealing with problems. A collaborative partnership with you yields the best outcomes within the shortest amount of time. Understanding your family is important in our work: the current family and the family of the past. Support for families experiencing drug/alcohol crises is available. Free initial consultation by telephone. email me at drbarbarajsuter@gmail.com
First we together bring rapid relief from your current upsets (e.g., anxiety, depression), before moving on to any deeper issues. We work together directly, actively, and with care, focusing on mutually agreed upon goals. Together we work emphasizing strengths as well as dealing with problems. A collaborative partnership with you yields the best outcomes within the shortest amount of time. Understanding your family is important in our work: the current family and the family of the past. Support for families experiencing drug/alcohol crises is available. Free initial consultation by telephone. email me at drbarbarajsuter@gmail.com
View
Photo of Karen Garman, Clinical Social Work/Therapist in Washington, DC
Karen Garman
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
Washington, DC 20015
I work with adults, adolescents and children to create a safe space in which to explore and understand struggles, develop healthy coping skills, and cultivate fulfilling relationships. I bring my understanding of development across the life span, listening skills, and a commitment to help each individual feel understood, supported, and challenged to move toward healing, growth, and the change they desire.
I work with adults, adolescents and children to create a safe space in which to explore and understand struggles, develop healthy coping skills, and cultivate fulfilling relationships. I bring my understanding of development across the life span, listening skills, and a commitment to help each individual feel understood, supported, and challenged to move toward healing, growth, and the change they desire.
(202) 729-9092 View (202) 729-9092
Photo of Eclectic DC, Clinical Social Work/Therapist in Washington, DC
Eclectic DC
Clinical Social Work/Therapist, LICSW, PMH-C, WPA
Verified Verified
1 Endorsed
Washington, DC 20018  (Online Only)
Waitlist for new clients
I identify as an ethicist; a Womanist who advocates and practices feminist ideals, cultural humility through continuous learning, bodily integrity, reproductive justice, sex work is work, pacifism by utilizing non-violent resistance techniques. I believe children have rights, whistleblowers are vital in society, I embrace LGBTQ+, Black Lives Matter is factual, and representation matters. I practice mindfulness with the philosophy of ‘margin to center’ action. I embody, advocate, and support activism in action and respect of human rights. Neither ever ends, even when it is inconvenient or uncomfortable. We must remain firmly resolved
I identify as an ethicist; a Womanist who advocates and practices feminist ideals, cultural humility through continuous learning, bodily integrity, reproductive justice, sex work is work, pacifism by utilizing non-violent resistance techniques. I believe children have rights, whistleblowers are vital in society, I embrace LGBTQ+, Black Lives Matter is factual, and representation matters. I practice mindfulness with the philosophy of ‘margin to center’ action. I embody, advocate, and support activism in action and respect of human rights. Neither ever ends, even when it is inconvenient or uncomfortable. We must remain firmly resolved
(202) 968-3652 View (202) 968-3652
Photo of David Pellegrini, Psychologist in Washington, DC
David Pellegrini
Psychologist, PhD
Verified Verified
Washington, DC 20007
I draw on 40+ years of experience in the practice of individual, group, and couples therapy. I work with a diversity of adult clients from varied circumstances and backgrounds. Nevertheless, they generally share a common aspiration to discover a more vital, passionate, and creative approach to meeting life's challenges. My intention is to establish a safe and authentic collaboration in pursuit of your aspirations and goals. I bring compassion, humor, insight and engagement to the therapeutic work. My approach integrates elements of the best, well-established therapeutic approaches, tailored to your unique needs and challenges.
I draw on 40+ years of experience in the practice of individual, group, and couples therapy. I work with a diversity of adult clients from varied circumstances and backgrounds. Nevertheless, they generally share a common aspiration to discover a more vital, passionate, and creative approach to meeting life's challenges. My intention is to establish a safe and authentic collaboration in pursuit of your aspirations and goals. I bring compassion, humor, insight and engagement to the therapeutic work. My approach integrates elements of the best, well-established therapeutic approaches, tailored to your unique needs and challenges.
(202) 559-4841 View (202) 559-4841
Photo of District Psychotherapy, Clinical Social Work/Therapist in Washington, DC
District Psychotherapy
Clinical Social Work/Therapist
Verified Verified
1 Endorsed
Washington, DC 20036
District Psychotherapy is a counseling practice serving Washington DC, Maryland, and Virginia. We specialize in young and middle-age adults (18-40’s) facing life challenges and/or mental health issues; or simply seeking greater fulfillment in life. Our most common treatment areas are anxiety, depression, career & relationship difficulties, ADHD, OCD, panic attacks, and trauma—among others. Sometimes just feeling stuck or adrift.
District Psychotherapy is a counseling practice serving Washington DC, Maryland, and Virginia. We specialize in young and middle-age adults (18-40’s) facing life challenges and/or mental health issues; or simply seeking greater fulfillment in life. Our most common treatment areas are anxiety, depression, career & relationship difficulties, ADHD, OCD, panic attacks, and trauma—among others. Sometimes just feeling stuck or adrift.
(833) 465-0720 View (833) 465-0720
Photo of Be.Here.Now.LLC, Licensed Professional Counselor in Washington, DC
Be.Here.Now.LLC
Licensed Professional Counselor, PhD, LPC, NCC, ACS, C-DBT
Verified Verified
11 Endorsed
Washington, DC 20036  (Online Only)
If you find yourself feeling stuck – trapped within the labyrinth of your own thoughts, navigating through intricate emotions, or struggling to connect with those around you – I would be honored to join you on a journey toward unlocking new possibilities. Guiding you through a transformative process is a privilege I hold dear. If anxiety, trauma, depression, emotional pain, or confusion are casting shadows over the quality of your life, please don't hesitate to reach out. Let's connect and explore how, together, we can pave a path for you to rediscover the joys of life in all their vibrancy.
If you find yourself feeling stuck – trapped within the labyrinth of your own thoughts, navigating through intricate emotions, or struggling to connect with those around you – I would be honored to join you on a journey toward unlocking new possibilities. Guiding you through a transformative process is a privilege I hold dear. If anxiety, trauma, depression, emotional pain, or confusion are casting shadows over the quality of your life, please don't hesitate to reach out. Let's connect and explore how, together, we can pave a path for you to rediscover the joys of life in all their vibrancy.
(202) 949-7141 View (202) 949-7141
Photo of Glen Bradley, Counselor in Washington, DC
Glen Bradley
Counselor, MA, LGPC
Verified Verified
1 Endorsed
Washington, DC 20037
Stop scrolling if you're looking for a therapist who is queer, specializes in trauma and LGBTQ+ affirming therapy, and wants you to talk about your mind-body connection. Ok, now breathe. Sigh. Come as you are. Being queer is a gift to the world. We are sparks of authenticity, joy, and zest! No two of us are alike. And yet, our community shares many themes: identity-based trauma, religious trauma, "missing out" on our childhood, "getting stuck" on pleasing others, limiting ourselves, delaying relationships, balancing other sources of identity, and–even if you've come out–feeling like something is still left unresolved.
Stop scrolling if you're looking for a therapist who is queer, specializes in trauma and LGBTQ+ affirming therapy, and wants you to talk about your mind-body connection. Ok, now breathe. Sigh. Come as you are. Being queer is a gift to the world. We are sparks of authenticity, joy, and zest! No two of us are alike. And yet, our community shares many themes: identity-based trauma, religious trauma, "missing out" on our childhood, "getting stuck" on pleasing others, limiting ourselves, delaying relationships, balancing other sources of identity, and–even if you've come out–feeling like something is still left unresolved.
(202) 900-3971 x5 View (202) 900-3971 x5
Photo of Heather Lyle Cassidy, Psychologist in Washington, DC
Heather Lyle Cassidy
Psychologist, PsyD
Verified Verified
3 Endorsed
Washington, DC 20008
I’m a clinical psychologist specializing in understanding relationships, both with yourself and with others. I graduated from a psychology doctoral program in 2004 and have worked at psychiatric and health rehabilitation hospitals, community mental health center, and long term care facilities, treating adolescents, adults and seniors. I have had a full- time private practice for over 13 years.
I’m a clinical psychologist specializing in understanding relationships, both with yourself and with others. I graduated from a psychology doctoral program in 2004 and have worked at psychiatric and health rehabilitation hospitals, community mental health center, and long term care facilities, treating adolescents, adults and seniors. I have had a full- time private practice for over 13 years.
(202) 251-5197 View (202) 251-5197
Photo of Avi Margolies, Psychologist in Washington, DC
Avi Margolies
Psychologist, PsyD
Verified Verified
14 Endorsed
Washington, DC 20036
Many people suffer under the weight of their sadness, fear, anger, and pain; others struggle to feel anything at all. Our self-esteem, relationships, or work can suffer as old cognitive, emotional, and behavioral paradigms are applied to new situations, often outside of our awareness. While it may seem daunting, exploring your thoughts, feelings, and experiences within the context of a safe therapeutic relationship can increase your access to, your awareness of, and your sense of control over your internal world. Through this process, you will find your strength, resilience, agency, and, ultimately, your freedom to more effectively shape your external world.
Many people suffer under the weight of their sadness, fear, anger, and pain; others struggle to feel anything at all. Our self-esteem, relationships, or work can suffer as old cognitive, emotional, and behavioral paradigms are applied to new situations, often outside of our awareness. While it may seem daunting, exploring your thoughts, feelings, and experiences within the context of a safe therapeutic relationship can increase your access to, your awareness of, and your sense of control over your internal world. Through this process, you will find your strength, resilience, agency, and, ultimately, your freedom to more effectively shape your external world.
(202) 765-3806 View (202) 765-3806
Photo of Raquel Grigera, Psychologist in Washington, DC
Raquel Grigera
Psychologist, PsyD
Verified Verified
1 Endorsed
Washington, DC 20003
Dr. Grigera is a licensed clinical psychologist who specializes in the treatment of eating disorders, mood and anxiety disorders, self-injury, suicidal ideation, trauma, and relationship concerns. She provides individualized evidence-based therapeutic services to children, adolescents, young adults, and families. She has extensive experience in conducting individual, group, and family therapy. Dr. Grigera has worked in a variety of settings, including private practices, public school systems, medical centers, and residential treatment centers.
Dr. Grigera is a licensed clinical psychologist who specializes in the treatment of eating disorders, mood and anxiety disorders, self-injury, suicidal ideation, trauma, and relationship concerns. She provides individualized evidence-based therapeutic services to children, adolescents, young adults, and families. She has extensive experience in conducting individual, group, and family therapy. Dr. Grigera has worked in a variety of settings, including private practices, public school systems, medical centers, and residential treatment centers.
(202) 831-2138 View (202) 831-2138
Photo of Paula Natalia Otero, Licensed Professional Counselor in Washington, DC
Paula Natalia Otero
Licensed Professional Counselor, LPC
Verified Verified
3 Endorsed
Washington, DC 20010
Not accepting new clients
You want to experience a meaningful and fulfilled life but instead you feel: Exhausted and depleted, paralyzed about anxiety and feeling uncertain about what is next, struggling to adjust to a new place, to a new life. Trying to figure out who you are by looking into "supposed to be"? Experiencing a different culture and trying to integrate with who "you have been"? On the outside, you seem to have things “under control” but deep inside you experience negative self-talk regularly.
You want to experience a meaningful and fulfilled life but instead you feel: Exhausted and depleted, paralyzed about anxiety and feeling uncertain about what is next, struggling to adjust to a new place, to a new life. Trying to figure out who you are by looking into "supposed to be"? Experiencing a different culture and trying to integrate with who "you have been"? On the outside, you seem to have things “under control” but deep inside you experience negative self-talk regularly.
(202) 851-2659 View (202) 851-2659
Photo of Ryan Long, Clinical Social Work/Therapist in Washington, DC
Ryan Long
Clinical Social Work/Therapist, LICSW, EMDR-C, IMGCA-C
Verified Verified
5 Endorsed
Washington, DC 20008
I specialize in working with adolescents and young adults. As a former high school coach and counselor, I provide a unique approach that is both authentic and encouraging in nature. I work best with clients that are open-minded and adaptable as well as introspective and contemplative. Sense of humor plays an essential role in developing the rapport I have with my clients. Once that is established, I make sure to carefully listen to each individual's unique story, assist in planning ahead for challenges, channel strengths, and collaboratively track progress together.
I specialize in working with adolescents and young adults. As a former high school coach and counselor, I provide a unique approach that is both authentic and encouraging in nature. I work best with clients that are open-minded and adaptable as well as introspective and contemplative. Sense of humor plays an essential role in developing the rapport I have with my clients. Once that is established, I make sure to carefully listen to each individual's unique story, assist in planning ahead for challenges, channel strengths, and collaboratively track progress together.
(202) 838-5376 View (202) 838-5376
Photo of Alec Spergel, Licensed Professional Counselor in Washington, DC
Alec Spergel
Licensed Professional Counselor, LPC
Verified Verified
Washington, DC 20003
I work with children, young adults, and adults facing a wide range of mental health issues.
I work with children, young adults, and adults facing a wide range of mental health issues.
(202) 935-7287 View (202) 935-7287
Photo of Tony Brunswick, Counselor in Washington, DC
Tony Brunswick
Counselor, LGPC, NCC, MS
Verified Verified
Washington, DC 20036
We all need support at different times in our lives. Navigating relationships, grief, life transitions, anxiety, loss, and trauma can be complex and overwhelming. If you are feeling stuck, lost, or unsure of what your next step should be, my approach to therapy focuses on helping you understand what troubles you and gain insight toward change that is positive and lasting. In my work with individuals and couples, I take a caring and collaborative approach to therapy to help you discover healing and meaning in your life and in your relationships.
We all need support at different times in our lives. Navigating relationships, grief, life transitions, anxiety, loss, and trauma can be complex and overwhelming. If you are feeling stuck, lost, or unsure of what your next step should be, my approach to therapy focuses on helping you understand what troubles you and gain insight toward change that is positive and lasting. In my work with individuals and couples, I take a caring and collaborative approach to therapy to help you discover healing and meaning in your life and in your relationships.
(202) 556-1984 View (202) 556-1984
Photo of Jennifer Hayes, Licensed Professional Counselor in Washington, DC
Jennifer Hayes
Licensed Professional Counselor, LMHC, LPC, CCTP, MAEd
Verified Verified
10 Endorsed
Washington, DC 20006  (Online Only)
Waitlist for new clients
I specialize in therapy for individuals and couples struggling with emotional, thought-based, and relational problems and those facing major life transitions, grief and trauma. I provide an engaged, safe and compassionate space where you can tell your story and explore how thoughts and past experiences impact the way you feel, behave, relate to others and manage life's challenges. I then assist you in finding healthy alternatives and an empowered path forward.
I specialize in therapy for individuals and couples struggling with emotional, thought-based, and relational problems and those facing major life transitions, grief and trauma. I provide an engaged, safe and compassionate space where you can tell your story and explore how thoughts and past experiences impact the way you feel, behave, relate to others and manage life's challenges. I then assist you in finding healthy alternatives and an empowered path forward.
View
Photo of Denise Jones, Clinical Social Work/Therapist in Washington, DC
Denise Jones
Clinical Social Work/Therapist, MSW, LICSW, LCSW-C, LCSW
Verified Verified
3 Endorsed
Washington, DC 20003  (Online Only)
As an EMDR Certified Therapist and Consultant, I use EMDR with clients who want an effective and clear-cut method to overcome the challenges of complex-PTSD, depression, and anxiety that can arise from relationship issues, life transitions, occupational plight, or issues of family, social, and cultural duress. In practice for over ten years, I am more than EMDR-trained. I exclusively use EMDR therapy with my clients, and I am actively connected to a national and international network of professionals dedicated to advancing EMDR treatment, research, and protocols. I also provide EMDR consultations for therapists.
As an EMDR Certified Therapist and Consultant, I use EMDR with clients who want an effective and clear-cut method to overcome the challenges of complex-PTSD, depression, and anxiety that can arise from relationship issues, life transitions, occupational plight, or issues of family, social, and cultural duress. In practice for over ten years, I am more than EMDR-trained. I exclusively use EMDR therapy with my clients, and I am actively connected to a national and international network of professionals dedicated to advancing EMDR treatment, research, and protocols. I also provide EMDR consultations for therapists.
(202) 803-7113 View (202) 803-7113
Photo of Julie Mitchell, Licensed Professional Counselor in Washington, DC
Julie Mitchell
Licensed Professional Counselor, LPC, LCPC
Verified Verified
8 Endorsed
Washington, DC 20036
Welcome! My primary goal as a therapist is to help you feel safe and comfortable exploring your concerns and challenges with me. Therapy can be both a difficult and rewarding endeavor, and I feel lucky to get to share with my clients in their fears, hopes, and joys. My hope is to help you feel comfortable and understood in delving into your own life and identifying areas where you wish for change. In my practice, I integrate elements of mindfulness, humanistic, and psychodynamic therapies to help you find new ways to relate to difficult emotions.
Welcome! My primary goal as a therapist is to help you feel safe and comfortable exploring your concerns and challenges with me. Therapy can be both a difficult and rewarding endeavor, and I feel lucky to get to share with my clients in their fears, hopes, and joys. My hope is to help you feel comfortable and understood in delving into your own life and identifying areas where you wish for change. In my practice, I integrate elements of mindfulness, humanistic, and psychodynamic therapies to help you find new ways to relate to difficult emotions.
(202) 813-1656 View (202) 813-1656
Photo of Dr. Claudia Mai Nguyen, Licensed Professional Counselor in Washington, DC
Dr. Claudia Mai Nguyen
Licensed Professional Counselor, PhD, LPC, NCC
Verified Verified
1 Endorsed
Washington, DC 20002
Often time life changes can fill us with a sense of being overwhelmed, disjointed or stuck--both physically and mentally. Whether you're looking to explore complex, deep-seated issues or need a supportive person and space in your life, I provide a safe, accepting, non-judgmental space for you to get the help you need. Processing painful experiences and emotions can be challenging, though I am committed to working collaboratively and supporting clients in becoming healthier and creating more rewarding and fulfilling relationships.
Often time life changes can fill us with a sense of being overwhelmed, disjointed or stuck--both physically and mentally. Whether you're looking to explore complex, deep-seated issues or need a supportive person and space in your life, I provide a safe, accepting, non-judgmental space for you to get the help you need. Processing painful experiences and emotions can be challenging, though I am committed to working collaboratively and supporting clients in becoming healthier and creating more rewarding and fulfilling relationships.
(571) 982-8149 View (571) 982-8149
Photo of Doug Eifert, Counselor in Washington, DC
Doug Eifert
Counselor, LGPC
Verified Verified
Washington, DC 20009
Life can place difficult obstacles in our path. Challenges at work, with relationships, or from our childhood can feel overwhelming. My goal is to help you move those obstacles out of your way. I specialize in supporting people challenged by anxiety, depression, emotional dysregulation, and substance use. I work with adults in individual and group therapy.
Life can place difficult obstacles in our path. Challenges at work, with relationships, or from our childhood can feel overwhelming. My goal is to help you move those obstacles out of your way. I specialize in supporting people challenged by anxiety, depression, emotional dysregulation, and substance use. I work with adults in individual and group therapy.
(855) 304-3630 x132 View (855) 304-3630 x132

How does your Therapist compare?

Number of Therapists in Washington, DC

2,000+

Average cost per session

$180

Therapists in Washington, DC who prioritize treating:

93% Anxiety
89% Depression
81% Relationship Issues
77% Self Esteem
68% Trauma and PTSD
68% Stress
65% Coping Skills

Average years in practice

13 Years

Top 3 insurances accepted

62% BlueCross and BlueShield
57% CareFirst
53% Cigna and Evernorth

How Therapists in Washington, DC see their clients

55% In Person and Online
45% Online Only

Gender breakdown

80% Female
19% Male
1% Non-Binary

FAQs - About Therapy and Counseling

How can I find a therapist in Washington?

Search for nearby therapists or counselors by inputting your city, town, or suburb; or zip code; or a provider’s name into the search bar. From there, you can filter providers by the issues they treat, cost, insurance, gender, and other factors to find providers who are well-suited to your needs. To navigate between locations within the same country, enter a new city or zip code into the search bar.

Learn more about how to find a therapist

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.