Therapists in Garden City, NY

Photo of Sandra DeSantis, Psychologist in Garden City, NY
Sandra DeSantis
Psychologist, PhD
Verified Verified
Garden City, NY 11530
As a solution-focused psychologist, my goal is to help you uncover your true potential and lead a life that is worth celebrating. While we can't change difficult situations of the past, we can work together to better understand and resolve the challenges in your life. By applying complementary therapy approaches and techniques, we will unearth long-standing behavior patterns or negative perceptions that may be holding you back from experiencing a more fulfilling and meaningful life.
As a solution-focused psychologist, my goal is to help you uncover your true potential and lead a life that is worth celebrating. While we can't change difficult situations of the past, we can work together to better understand and resolve the challenges in your life. By applying complementary therapy approaches and techniques, we will unearth long-standing behavior patterns or negative perceptions that may be holding you back from experiencing a more fulfilling and meaningful life.
(516) 714-4307 View (516) 714-4307
Photo of Angelique Yemma Creative Arts Therapy Source, Creative Arts Therapist in Garden City, NY
Angelique Yemma Creative Arts Therapy Source
Creative Arts Therapist, BC-DMT, LCAT
Verified Verified
2 Endorsed
Garden City, NY 11530
I am a solution-focused therapist dedicated to helping children, youth, and young adults successfully manage life transitions. By actively listening to their needs and goals, I tailor my approach to align with what they want and why—whether they're coping with changes in their family, school, or personal life. Together, we explore effective strategies that not only address their immediate challenges but also build resilience and skills for future success.
I am a solution-focused therapist dedicated to helping children, youth, and young adults successfully manage life transitions. By actively listening to their needs and goals, I tailor my approach to align with what they want and why—whether they're coping with changes in their family, school, or personal life. Together, we explore effective strategies that not only address their immediate challenges but also build resilience and skills for future success.
(516) 973-4397 View (516) 973-4397
Photo of Amanda Marcus, LCSW, Clinical Social Work/Therapist in Garden City, NY
Amanda Marcus, LCSW
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Garden City, NY 11530
Therapy is an exciting time of growth, self-realization and change. I can help you on your journey of healing, self-exploration and self-actualization. I completed my master's degree from NYU and have post-graduate training and extensive clinical experience working with eating disorders but work with a wide variety of mental health concerns. I am a former clinical director of a residential eating disorder facility and I will collaborate with your treatment team if you are seeking eating disorder treatment. I offer a free phone consultation to see how I can help you reach your personal goals.
Therapy is an exciting time of growth, self-realization and change. I can help you on your journey of healing, self-exploration and self-actualization. I completed my master's degree from NYU and have post-graduate training and extensive clinical experience working with eating disorders but work with a wide variety of mental health concerns. I am a former clinical director of a residential eating disorder facility and I will collaborate with your treatment team if you are seeking eating disorder treatment. I offer a free phone consultation to see how I can help you reach your personal goals.
(516) 265-7044 View (516) 265-7044
Photo of Inspiring Wellness, Clinical Social Work/Therapist in Garden City, NY
Inspiring Wellness
Clinical Social Work/Therapist, LMSW
Verified Verified
Garden City, NY 11530
Hanna Clair is a NYS Licensed Social Worker who received her Master’s Degree from New York University in Manhattan. She has extensive experience working with and supporting children and adolescents to enhance their social emotional well-being. Hanna has worked with individuals with Depression, Anxiety, ADHD, Oppositional Defiant Disorder and autism in a school setting.
Hanna Clair is a NYS Licensed Social Worker who received her Master’s Degree from New York University in Manhattan. She has extensive experience working with and supporting children and adolescents to enhance their social emotional well-being. Hanna has worked with individuals with Depression, Anxiety, ADHD, Oppositional Defiant Disorder and autism in a school setting.
(631) 919-4892 View (631) 919-4892
Photo of Naomi Foxbruner, Clinical Social Work/Therapist in Garden City, NY
Naomi Foxbruner
Clinical Social Work/Therapist, LMSW
Verified Verified
1 Endorsed
Garden City, NY 11530
I strive to create an open and comfortable environment where individuals can feel safe to be in touch with their inner experiences. I believe we all have the ability to lead meaningful, satisfying lives, and with the right focus and support, it is always within reach. I strive to help my clients find the goodness in their own lives, though often it may be hard and confusing. It is my greatest hope and pleasure to be a supporter, to help people navigate their way through relationships and challenges, allowing them to live life in a meaningful way.
I strive to create an open and comfortable environment where individuals can feel safe to be in touch with their inner experiences. I believe we all have the ability to lead meaningful, satisfying lives, and with the right focus and support, it is always within reach. I strive to help my clients find the goodness in their own lives, though often it may be hard and confusing. It is my greatest hope and pleasure to be a supporter, to help people navigate their way through relationships and challenges, allowing them to live life in a meaningful way.
(516) 969-8845 View (516) 969-8845
Photo of Crystal Comerchero, Clinical Social Work/Therapist in Garden City, NY
Crystal Comerchero
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Garden City, NY 11530
Crystal is a Licensed Clinical Social Worker (LCSW) with years of experience working with adolescents and adults who struggle with depression, anxiety, bipolar disorder, PTSD, schizophrenia, ADHD and substance abuse. She creates a non-judgmental, inclusive and supportive environment so clients feel safe to share what is going on in their minds and lives. Through a person-centered, strength based and trauma informed therapeutic approach she helps people identify their treatment goals. She incorporates skills from Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Solution Focused Therapy, Motivational Interview
Crystal is a Licensed Clinical Social Worker (LCSW) with years of experience working with adolescents and adults who struggle with depression, anxiety, bipolar disorder, PTSD, schizophrenia, ADHD and substance abuse. She creates a non-judgmental, inclusive and supportive environment so clients feel safe to share what is going on in their minds and lives. Through a person-centered, strength based and trauma informed therapeutic approach she helps people identify their treatment goals. She incorporates skills from Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Solution Focused Therapy, Motivational Interview
(516) 747-1470 View (516) 747-1470
Photo of Diana Damilatis in Garden City, NY
Diana Damilatis
MA, LMHC
Verified Verified
Garden City, NY 11530  (Online Only)
Waitlist for new clients
I am a licensed Mental Health Counselor. I am an integrative psychotherapist who truly believes in viewing individuals through a holistic perspective. I work in a private practice, known as Image Therapy Services. Image Therapy Services provides psychotherapy to teens, young adults, couples, and families. We address developmental disabilities, depression, anxiety, and addiction. Our goal is to restore a balance to improve self-image and functioning. I also work as the Assistant Director for the Bridges to Adelphi Program, which is a program at Adelphi University that provides Academic, Social, and Vocational Services to students with Autism Spectrum Disorder, or other nonverbal learning disorders.
I am a licensed Mental Health Counselor. I am an integrative psychotherapist who truly believes in viewing individuals through a holistic perspective. I work in a private practice, known as Image Therapy Services. Image Therapy Services provides psychotherapy to teens, young adults, couples, and families. We address developmental disabilities, depression, anxiety, and addiction. Our goal is to restore a balance to improve self-image and functioning. I also work as the Assistant Director for the Bridges to Adelphi Program, which is a program at Adelphi University that provides Academic, Social, and Vocational Services to students with Autism Spectrum Disorder, or other nonverbal learning disorders.
(631) 759-8397 View (631) 759-8397
Photo of Long Island Hope Counseling Services LLC, Counselor in Garden City, NY
Long Island Hope Counseling Services LLC
Counselor, PhD, LMHC, LPC, NCC
Verified Verified
1 Endorsed
Garden City, NY 11530
Waitlist for new clients
Dr. Angela Fung is a licensed mental health counselor and adjunct instructor in the Master’s Program for Counseling for Mental Health & Wellness at New York University. She finds great joy in walking alongside her clients through a meaningful journey of healing and behavioral transformation. Angela’s many years of working with individuals, couples, and groups have shaped her approach to client centered counseling and compassionate care.
Dr. Angela Fung is a licensed mental health counselor and adjunct instructor in the Master’s Program for Counseling for Mental Health & Wellness at New York University. She finds great joy in walking alongside her clients through a meaningful journey of healing and behavioral transformation. Angela’s many years of working with individuals, couples, and groups have shaped her approach to client centered counseling and compassionate care.
(516) 980-3936 View (516) 980-3936
Photo of D. Lani McElgun, Marriage & Family Therapist in Garden City, NY
D. Lani McElgun
Marriage & Family Therapist, MA, LMFT
Verified Verified
Garden City, NY 11530
Not accepting new clients
Hello and welcome. As a licensed marriage and family therapist, I provide therapy services to individuals, couples and families on a wide range of topics, including but not limited to pre-marital, adolescents, blended/stepfamilies, anxiety/stress, anger, divorce, midlife issues. Therapy is goal oriented utilizing a professional, educational and empathetic approach. I look forward to hearing from you so that we can begin the process of working together to achieving your goals.
Hello and welcome. As a licensed marriage and family therapist, I provide therapy services to individuals, couples and families on a wide range of topics, including but not limited to pre-marital, adolescents, blended/stepfamilies, anxiety/stress, anger, divorce, midlife issues. Therapy is goal oriented utilizing a professional, educational and empathetic approach. I look forward to hearing from you so that we can begin the process of working together to achieving your goals.
(516) 513-8354 View (516) 513-8354
Photo of Paula V Gonthier, Clinical Social Work/Therapist in Garden City, NY
Paula V Gonthier
Clinical Social Work/Therapist, LCSW
Verified Verified
Garden City, NY 11530
I believe that you, as a unique individual, have a deep well of strengths and talents which you may sometimes struggle to fully access due to any number of difficulties and roadblocks you have encountered in your lifetime. These roadblocks can interfere with any aspect of your life, whether it be finding and maintaining a truly meaningful relationship, identifying and pursuing a satisfying career, dealing with the seemingly unbearable loss of someone you love, or simply attaining a feeling of inner calm from which you can more successfully face all the challenges in your life.
I believe that you, as a unique individual, have a deep well of strengths and talents which you may sometimes struggle to fully access due to any number of difficulties and roadblocks you have encountered in your lifetime. These roadblocks can interfere with any aspect of your life, whether it be finding and maintaining a truly meaningful relationship, identifying and pursuing a satisfying career, dealing with the seemingly unbearable loss of someone you love, or simply attaining a feeling of inner calm from which you can more successfully face all the challenges in your life.
(516) 862-2646 View (516) 862-2646
Photo of Catherine Faro, Clinical Social Work/Therapist in Garden City, NY
Catherine Faro
Clinical Social Work/Therapist, LCSW
Verified Verified
Garden City, NY 11530
Maybe recently your life hasn’t been going the way you envisioned. Maybe you are struggling with a new challenging situation in the face of a big change. Maybe a relatively small issue has become what your daily life is now centered on. Or, maybe you can’t put your finger on what is bothering you, but you haven’t been yourself lately. It can feel like “no one knows how this feels”, or “things could get worse”, but it can also feel like “I’ve already wasted so much time”. You are here and I want to be the first person to welcome you in taking the first step toward finding whatever it is you are looking for.
Maybe recently your life hasn’t been going the way you envisioned. Maybe you are struggling with a new challenging situation in the face of a big change. Maybe a relatively small issue has become what your daily life is now centered on. Or, maybe you can’t put your finger on what is bothering you, but you haven’t been yourself lately. It can feel like “no one knows how this feels”, or “things could get worse”, but it can also feel like “I’ve already wasted so much time”. You are here and I want to be the first person to welcome you in taking the first step toward finding whatever it is you are looking for.
(516) 789-3221 View (516) 789-3221
Photo of Erica James, Marriage & Family Therapist in Garden City, NY
Erica James
Marriage & Family Therapist, MS, LMFT
Verified Verified
Garden City, NY 11530
Has your relationship lost that “spark” that it once had? Do you and your partner find yourselves in the same cycle of fighting over seemingly meaningless things? Do you find yourself constantly on edge over things your partner says or does? Does it feel like there isn’t any romance, intimacy, or sex anymore? Do you feel stuck and hopeless? It can feel like you’re with a different person or someone that you don’t even know anymore. The arguments seem to happen more frequently and feel more intense. This leads to resentment and anger, which only continues the argumentative cycle. Being in this place can feel hopeless and hurtful.
Has your relationship lost that “spark” that it once had? Do you and your partner find yourselves in the same cycle of fighting over seemingly meaningless things? Do you find yourself constantly on edge over things your partner says or does? Does it feel like there isn’t any romance, intimacy, or sex anymore? Do you feel stuck and hopeless? It can feel like you’re with a different person or someone that you don’t even know anymore. The arguments seem to happen more frequently and feel more intense. This leads to resentment and anger, which only continues the argumentative cycle. Being in this place can feel hopeless and hurtful.
(516) 347-2512 View (516) 347-2512
Photo of Anella C Pereira, Marriage & Family Therapist in Garden City, NY
Anella C Pereira
Marriage & Family Therapist, MA, LMFT
Verified Verified
Garden City, NY 11530  (Online Only)
I provide bilingual (Spanish and English) short term, goal oriented individual, couples and family therapy within a humanistic framework. My areas of specialization include working with children, adolescents, adults, couples and families dealing with behavior, low self-esteem, anxiety, relationship and multi-cultural issues and those experiencing crisis and traumatic stress. I work hand in hand with community agencies providing support services to victims of domestic violence. My passion for the profession and empathetic approach has inspired my clients' trust. I create a safe and supportive environment where, in collaboration with my clients, we explore solutions bringing about positive change.
I provide bilingual (Spanish and English) short term, goal oriented individual, couples and family therapy within a humanistic framework. My areas of specialization include working with children, adolescents, adults, couples and families dealing with behavior, low self-esteem, anxiety, relationship and multi-cultural issues and those experiencing crisis and traumatic stress. I work hand in hand with community agencies providing support services to victims of domestic violence. My passion for the profession and empathetic approach has inspired my clients' trust. I create a safe and supportive environment where, in collaboration with my clients, we explore solutions bringing about positive change.
(516) 495-3206 View (516) 495-3206
Photo of Ami Schwab, Psychologist in Garden City, NY
Ami Schwab
Psychologist, PhD
Verified Verified
4 Endorsed
Garden City, NY 11530  (Online Only)
Compassion is one key used in treating children and adolescents with anxiety, depression, attention-deficit hyperactivity disorder (ADHD), and other difficulties together with their parents. In addition to guiding children to strategies to manage adversity, I teach parents how to reinforce these tactics at home between sessions. With this method, children improve quicker than they would with just one hour per week of treatment.
Compassion is one key used in treating children and adolescents with anxiety, depression, attention-deficit hyperactivity disorder (ADHD), and other difficulties together with their parents. In addition to guiding children to strategies to manage adversity, I teach parents how to reinforce these tactics at home between sessions. With this method, children improve quicker than they would with just one hour per week of treatment.
(646) 846-4162 View (646) 846-4162
Photo of Randi Shelowitz, Clinical Social Work/Therapist in Garden City, NY
Randi Shelowitz
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Garden City, NY 11530
Randi Shelowitz is a NY State Licensed Clinical Social Worker specializing in providing psychotherapeutic services for Children, Adolescents and Adults. Over the course of her 30 years of experience, she is known best for her ability to connect to her patients, and their families with compassion and understanding. She has strong skills in the areas of both diagnosing mental illnesses, and creating attainable plans of treatment for her patients. Randi grew up playing competitive softball and beach volleyball, and continues to be guided by these team principles in her practice.
Randi Shelowitz is a NY State Licensed Clinical Social Worker specializing in providing psychotherapeutic services for Children, Adolescents and Adults. Over the course of her 30 years of experience, she is known best for her ability to connect to her patients, and their families with compassion and understanding. She has strong skills in the areas of both diagnosing mental illnesses, and creating attainable plans of treatment for her patients. Randi grew up playing competitive softball and beach volleyball, and continues to be guided by these team principles in her practice.
(516) 963-1851 View (516) 963-1851
Photo of Lisa Phillips Creative Arts Therapy Source, Art Therapist in Garden City, NY
Lisa Phillips Creative Arts Therapy Source
Art Therapist, ATR-BC , LCAT, ATCS
Verified Verified
4 Endorsed
Garden City, NY 11530
When life feels like a constant struggle, sometimes the only way to heal is to experience something from a new perspective. The therapists at Creative Arts Therapy Source are compassionate psychotherapists specializing in innovative approaches to help you live a life of ease. As an Art Therapist, Lisa provides creative approaches when working with adults and couples to express feelings that are beyond words.
When life feels like a constant struggle, sometimes the only way to heal is to experience something from a new perspective. The therapists at Creative Arts Therapy Source are compassionate psychotherapists specializing in innovative approaches to help you live a life of ease. As an Art Therapist, Lisa provides creative approaches when working with adults and couples to express feelings that are beyond words.
(516) 962-2957 View (516) 962-2957
Photo of Kevin Smedman in Garden City, NY
Kevin Smedman
LMSW
Verified Verified
1 Endorsed
Garden City, NY 11530  (Online Only)
Do you feel you want more from life? Have you thought about making changes but don't know where to start? Do you feel like every time you try to make changes, you just fall back into the same old patterns? If so, you're not alone. The human brain is wired to not like change, and can keep us stuck in limiting thought patterns which make it difficult to reach our goals. Therapy is a powerful tool that can help you better control your thoughts, heal trauma, develop healthy habits, and be more intentional with your actions. You deserve to have the life you've always dreamed of. Let's work together to help you get there.
Do you feel you want more from life? Have you thought about making changes but don't know where to start? Do you feel like every time you try to make changes, you just fall back into the same old patterns? If so, you're not alone. The human brain is wired to not like change, and can keep us stuck in limiting thought patterns which make it difficult to reach our goals. Therapy is a powerful tool that can help you better control your thoughts, heal trauma, develop healthy habits, and be more intentional with your actions. You deserve to have the life you've always dreamed of. Let's work together to help you get there.
(516) 226-7835 View (516) 226-7835
Cindy Leinwand
Clinical Social Work/Therapist, LCSW
Verified Verified
Garden City, NY 11530
There are times when seeking the support of a therapist is necessary to navigate life's challenges. Finding a therapist who can best meet your needs can also be challenging. My extensive experience can ease that task.
There are times when seeking the support of a therapist is necessary to navigate life's challenges. Finding a therapist who can best meet your needs can also be challenging. My extensive experience can ease that task.
(516) 570-9656 View (516) 570-9656
Photo of Nick Michael, Clinical Social Work/Therapist in Garden City, NY
Nick Michael
Clinical Social Work/Therapist, LCSW
Verified Verified
15 Endorsed
Garden City, NY 11530
I provide counseling and psychotherapy to children, adolescents, adults and families. My areas of specialty include treating Anxiety and/or Depression, ADD/ADHD, Obsessions / Compulsions, Oppositional Defiant Children / Teens, Substance Abusing Teens / Young Adults and Parent Counseling.
I provide counseling and psychotherapy to children, adolescents, adults and families. My areas of specialty include treating Anxiety and/or Depression, ADD/ADHD, Obsessions / Compulsions, Oppositional Defiant Children / Teens, Substance Abusing Teens / Young Adults and Parent Counseling.
(516) 482-1625 View (516) 482-1625
Photo of Rosemary Flanagan, Psychologist in Garden City, NY
Rosemary Flanagan
Psychologist, PhD, ABPP
Verified Verified
Garden City, NY 11530
I work best with persistent persons wanting a better quality of life. Because it can be difficult to seek help, I provide psychoeducation about therapy to clients and am forthright and supportive. So if you are feeling anxious or sad, have worries, or are worried about a family skills and functioning, I am able to help. Those who are motivated to do better and want relief from work, care giving, social and family stresses can benefit from my approach to therapy. It is important to remember that each person is an individual who has his or her individual concerns.
I work best with persistent persons wanting a better quality of life. Because it can be difficult to seek help, I provide psychoeducation about therapy to clients and am forthright and supportive. So if you are feeling anxious or sad, have worries, or are worried about a family skills and functioning, I am able to help. Those who are motivated to do better and want relief from work, care giving, social and family stresses can benefit from my approach to therapy. It is important to remember that each person is an individual who has his or her individual concerns.
(516) 272-4551 View (516) 272-4551

How does your Therapist compare?

Number of Therapists in Garden City, NY

300+

Average cost per session

$175

Therapists in Garden City, NY who prioritize treating:

95% Anxiety
92% Depression
81% Relationship Issues
78% Self Esteem
72% Coping Skills
67% Trauma and PTSD
65% Stress

Average years in practice

14 Years

Top 3 insurances accepted

79% Aetna
67% Cigna and Evernorth
63% UnitedHealthcare UHC | UBH

How Therapists in Garden City, NY see their clients

74% In Person and Online
26% Online Only

Gender breakdown

85% Female
14% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Garden City?

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.