Therapists in Howard City, MI

Photo of Christi Sommers, Counselor, MS, LLPC
Christi Sommers
Counselor, MS, LLPC
Howard City, MI 49329
My ideal client is someone feeling stuck, whether due to anxiety, depression, life transitions, or relationship struggles. They may feel overwhelmed, disconnected, or uncertain about their direction. They want to feel better, but more than that, they want sangicity, peace, and purpose. Their goal is not just symptom relief but meaningful change: stronger relationships, greater self-understanding, and an authentic and fulfilling life.
My ideal client is someone feeling stuck, whether due to anxiety, depression, life transitions, or relationship struggles. They may feel overwhelmed, disconnected, or uncertain about their direction. They want to feel better, but more than that, they want sangicity, peace, and purpose. Their goal is not just symptom relief but meaningful change: stronger relationships, greater self-understanding, and an authentic and fulfilling life.
(231) 508-9746 View (231) 508-9746
Photo of Sarah Dorris, Licensed Professional Counselor, LPC, CCTP-II, C-DBT
Sarah Dorris
Licensed Professional Counselor, LPC, CCTP-II, C-DBT
Howard City, MI 49329
As a clinician, I am passionate about helping others with depression, OCD, anxiety and trauma get past problems such as missing out on social connections and events or interfering with one's ability to work or go to school. I also have experience with mood disorders, which can lead to feeling stuck and feeling weighed down by things going wrong. It's a myth that struggling is not a normal part of life or that it's something to be ashamed of. I can help by providing knowledge and skills to become persistent and resilient in order to get around setbacks and roadblocks and find a life worth living.
As a clinician, I am passionate about helping others with depression, OCD, anxiety and trauma get past problems such as missing out on social connections and events or interfering with one's ability to work or go to school. I also have experience with mood disorders, which can lead to feeling stuck and feeling weighed down by things going wrong. It's a myth that struggling is not a normal part of life or that it's something to be ashamed of. I can help by providing knowledge and skills to become persistent and resilient in order to get around setbacks and roadblocks and find a life worth living.
(616) 523-3234 View (616) 523-3234
Photo of Kimberlee Gugliotta, Licensed Professional Counselor, MA, LLPC
Kimberlee Gugliotta
Licensed Professional Counselor, MA, LLPC
Howard City, MI 49329
Taking the first step to enter into therapy can be the most difficult, but I am here to walk with you through the entire process. As a clinician, I strive to create a warm, welcoming, and supportive space where every client can feel safe to join me on this therapeutic journey. We will work together to explore your concerns, create treatment goals, and identify effective strategies and techniques that will guide you towards your wellness goals.
Taking the first step to enter into therapy can be the most difficult, but I am here to walk with you through the entire process. As a clinician, I strive to create a warm, welcoming, and supportive space where every client can feel safe to join me on this therapeutic journey. We will work together to explore your concerns, create treatment goals, and identify effective strategies and techniques that will guide you towards your wellness goals.
(616) 226-6522 View (616) 226-6522
Photo of Bethany Doneth, Clinical Social Work/Therapist, LMSW
Bethany Doneth
Clinical Social Work/Therapist, LMSW
1 Endorsed
Howard City, MI 49329
Hi, I am a Masters Level Social Worker who, for the last ten years, have been working with individuals with chronic medical illnesses. I am presently working with individuals who struggle with day-to-day stressors, mood shifts, and balancing life challenges. If you struggle with doing daily activities that seem to prohibit you from enjoying life, then please email me. I will meet you where you are at and work together to ensure you develop the tools needed to help bring your life to where you can find your happiness. Life can be difficult and asking for help is the best way to start.
Hi, I am a Masters Level Social Worker who, for the last ten years, have been working with individuals with chronic medical illnesses. I am presently working with individuals who struggle with day-to-day stressors, mood shifts, and balancing life challenges. If you struggle with doing daily activities that seem to prohibit you from enjoying life, then please email me. I will meet you where you are at and work together to ensure you develop the tools needed to help bring your life to where you can find your happiness. Life can be difficult and asking for help is the best way to start.
(616) 441-3627 View (616) 441-3627
Photo of Ann Bixler, Limited Licensed Psychologist, LLP, LPC, ICAADC, RPT-S
Ann Bixler
Limited Licensed Psychologist, LLP, LPC, ICAADC, RPT-S
Serves Area
I 've been in private practice since 1997. Throughout that time I have continued to expand on my knowledge and develop specialties in play therapy, working with the LGBTQ community, substance abuse, and trauma including PTSD. I work with clients experiencing anxiety and depression. I see each client as unique and feel honored to join them in their journey towards health and wellness. I am affiliated with organizations that keep me abreast of evidence-based practices for the unique situations that clients bring to therapy.
I 've been in private practice since 1997. Throughout that time I have continued to expand on my knowledge and develop specialties in play therapy, working with the LGBTQ community, substance abuse, and trauma including PTSD. I work with clients experiencing anxiety and depression. I see each client as unique and feel honored to join them in their journey towards health and wellness. I am affiliated with organizations that keep me abreast of evidence-based practices for the unique situations that clients bring to therapy.
(616) 312-2470 View (616) 312-2470
Photo of Thomas J. Rundquist - Nova Counseling Associates Inc, Counselor, MA, LPC
Nova Counseling Associates Inc
Counselor, MA, LPC
Serves Area
Over 40 years of experience Tom Rundquist, M.A. LPC can help you get through your situation with new satisfaction. Great rates and open 7 days a week to accommodate anyone at any point in time.Next day appointments upon request. Tom is a holistic health practitioner. Editor of a prevention game Horse is Boss (Drug Culture Monopoly) 3rd Ed.based on his recovering ex-addicts in Detroit.See Amazon. Located on N.State ( Business North US 131) across from Old Airport Hanger, two houses south of Rivertown Realty. By appointment only. If driver gets false alcohol reading on interlock, do ETG urine ($40).
Over 40 years of experience Tom Rundquist, M.A. LPC can help you get through your situation with new satisfaction. Great rates and open 7 days a week to accommodate anyone at any point in time.Next day appointments upon request. Tom is a holistic health practitioner. Editor of a prevention game Horse is Boss (Drug Culture Monopoly) 3rd Ed.based on his recovering ex-addicts in Detroit.See Amazon. Located on N.State ( Business North US 131) across from Old Airport Hanger, two houses south of Rivertown Realty. By appointment only. If driver gets false alcohol reading on interlock, do ETG urine ($40).
(231) 399-8750 View (231) 399-8750
Photo of Marissa Struble, Clinical Social Work/Therapist, LLMSW
Marissa Struble
Clinical Social Work/Therapist, LLMSW
1 Endorsed
Serves Area
I am deeply passionate about fostering resilience and healing through trauma- informed care. Having worked alongside children and families navigating challenging circumstances, where I witnessed firsthand the profound impact that trauma can have. I understand the complexities of trauma and its ripple effects on emotional, physical, spiritual, and psychological well-being.
I am deeply passionate about fostering resilience and healing through trauma- informed care. Having worked alongside children and families navigating challenging circumstances, where I witnessed firsthand the profound impact that trauma can have. I understand the complexities of trauma and its ripple effects on emotional, physical, spiritual, and psychological well-being.
(616) 737-8560 View (616) 737-8560

More Therapists Nearby

Photo of Tracy A Zavala, Licensed Professional Counselor, LPC, NCC
Tracy A Zavala
Licensed Professional Counselor, LPC, NCC
2 Endorsed
Online Only
Waitlist for new clients
We all have times when we need help with getting through the challenges of life. Whether you are experiencing anxiety, depression, other mental health concerns; or perhaps parenting a child with emotional and behavioral concerns, I am glad to help. I have twenty plus years of experience working with individuals and families in settings including: partial hospitalization, preschool, juvenile court, adolescent residential treatment, nonprofit organizations and community mental health. Contact me to discuss your needs and how I may best assist you, or your child/family.
We all have times when we need help with getting through the challenges of life. Whether you are experiencing anxiety, depression, other mental health concerns; or perhaps parenting a child with emotional and behavioral concerns, I am glad to help. I have twenty plus years of experience working with individuals and families in settings including: partial hospitalization, preschool, juvenile court, adolescent residential treatment, nonprofit organizations and community mental health. Contact me to discuss your needs and how I may best assist you, or your child/family.
(616) 414-3186 View (616) 414-3186
Photo of Lesli Richardson, Counselor, LLPC, MEd, MA
Lesli Richardson
Counselor, LLPC, MEd, MA
5 Endorsed
Grand Rapids, MI 49525
My hope is to have clients who will be honest with me and let me help them where they are in their life path. Clients should try to be willing to challenge themselves and to trust the therapeutic process. The goal is to keep working on positive growth and not expect perfection. Finding connection without judgement can be transformative! I have partnered with clients from many different backgrounds and treat everyone with respect, dignity, and integrity. I value relationships. I have been told my greatest strengths include honesty, asking great questions, being straight forward, a good listener/ problem solver, and providing hope.
My hope is to have clients who will be honest with me and let me help them where they are in their life path. Clients should try to be willing to challenge themselves and to trust the therapeutic process. The goal is to keep working on positive growth and not expect perfection. Finding connection without judgement can be transformative! I have partnered with clients from many different backgrounds and treat everyone with respect, dignity, and integrity. I value relationships. I have been told my greatest strengths include honesty, asking great questions, being straight forward, a good listener/ problem solver, and providing hope.
(616) 919-6506 View (616) 919-6506
Photo of Ashley Doyle, Counselor, MA, LLPC
Ashley Doyle
Counselor, MA, LLPC
1 Endorsed
Serves Area
Are you feeling overwhelmed with anxiety or obsessive thoughts and compulsions, struggling to keep it all at bay? You might be experiencing intrusive thoughts, persistent worry, or feeling constantly on edge. Anxious thoughts, and unrelenting worry prevents you from being present, focusing at work, or simply experiencing joy in your life. Anxiety and OCD is exhausting, you deserve to be free from its grip! Maybe you've tried to manage on your own, but now you need help finding your way through it. You want to break out of the cycle and find calm and peace within yourself, with the right tools this is possible. I can help.
Are you feeling overwhelmed with anxiety or obsessive thoughts and compulsions, struggling to keep it all at bay? You might be experiencing intrusive thoughts, persistent worry, or feeling constantly on edge. Anxious thoughts, and unrelenting worry prevents you from being present, focusing at work, or simply experiencing joy in your life. Anxiety and OCD is exhausting, you deserve to be free from its grip! Maybe you've tried to manage on your own, but now you need help finding your way through it. You want to break out of the cycle and find calm and peace within yourself, with the right tools this is possible. I can help.
(616) 691-6378 View (616) 691-6378
Photo of Kim Bartz, Clinical Social Work/Therapist, LMSW
Kim Bartz
Clinical Social Work/Therapist, LMSW
Online Only
It takes courage to go to a counselor for help. Whether you are struggling with an on-going issue, or just going through a rough time in life, whether you are dealing with anxiety, depression, stress, adjustment to a new situation, grief/loss, mood issues, or something else, working with a counselor will help. The good news is that because you are willing to reach out for a helping hand, you already have a good start on what it takes to achieve the change you are looking to make! You have awareness and willingness; 2 ingredients for success!
It takes courage to go to a counselor for help. Whether you are struggling with an on-going issue, or just going through a rough time in life, whether you are dealing with anxiety, depression, stress, adjustment to a new situation, grief/loss, mood issues, or something else, working with a counselor will help. The good news is that because you are willing to reach out for a helping hand, you already have a good start on what it takes to achieve the change you are looking to make! You have awareness and willingness; 2 ingredients for success!
(616) 414-3053 View (616) 414-3053
Photo of Brendan Kelly - The Well Being, Counseling and Fitness Center, Clinical Social Work/Therapist, LMSW, LPC
The Well Being, Counseling and Fitness Center
Clinical Social Work/Therapist, LMSW, LPC
Serves Area
Come to The Well Being to "Get Help, Get Active, Get Well." The Well Being is a counseling practice that is staffed by skilled, licensed, and experienced therapists and utilizes movement and exercise as a direct component of treatment. We offer traditional outpatient counseling services for adults specializing in depression, anxiety, grief/loss, relationships, trauma, and other common mental health concerns, utilizing such techniques as CBT, EMDR, ACT, EFT, Mindfulness or Solution Focused Therapy. For people who find themselves struggling with their mental health, and struggling to be physically active, give us a call!
Come to The Well Being to "Get Help, Get Active, Get Well." The Well Being is a counseling practice that is staffed by skilled, licensed, and experienced therapists and utilizes movement and exercise as a direct component of treatment. We offer traditional outpatient counseling services for adults specializing in depression, anxiety, grief/loss, relationships, trauma, and other common mental health concerns, utilizing such techniques as CBT, EMDR, ACT, EFT, Mindfulness or Solution Focused Therapy. For people who find themselves struggling with their mental health, and struggling to be physically active, give us a call!
(616) 710-3953 View (616) 710-3953
Photo of Taylor Paige Villano, Clinical Social Work/Therapist, LCSW
Taylor Paige Villano
Clinical Social Work/Therapist, LCSW
1 Endorsed
Online Only
Welcome! I am a dedicated mental health provider specializing in therapy for children, teens, young adults, and families facing challenges such as anxiety, trauma, and low self-esteem. With a compassionate approach, I utilize a variety of therapeutic methods to help clients uncover the root of their struggles and foster healing. I am committed to creating a supportive environment where individuals can explore their experiences and unlock their full potential, empowering them to lead fulfilling and resilient lives.
Welcome! I am a dedicated mental health provider specializing in therapy for children, teens, young adults, and families facing challenges such as anxiety, trauma, and low self-esteem. With a compassionate approach, I utilize a variety of therapeutic methods to help clients uncover the root of their struggles and foster healing. I am committed to creating a supportive environment where individuals can explore their experiences and unlock their full potential, empowering them to lead fulfilling and resilient lives.
View
Photo of AC Cluley - Big Rapids Counseling, Master Social Worker, LLMSW
Big Rapids Counseling
Master Social Worker, LLMSW
Online Only
Hablo español Are you navigating the world as an AuDHD, queer, trans/nonbinary, Latine, BIPOC, or Indoqueer person and looking for a therapist who understands how complicated those intersections can be? I offer a grounded, compassionate space where you don’t have to mask or explain the basics of who you are. My perspective is shaped both by my clinical training and by my own experiences growing up in rural Michigan, navigating foster care and housing instability, and later pursuing my education and publishing a poetry book.
Hablo español Are you navigating the world as an AuDHD, queer, trans/nonbinary, Latine, BIPOC, or Indoqueer person and looking for a therapist who understands how complicated those intersections can be? I offer a grounded, compassionate space where you don’t have to mask or explain the basics of who you are. My perspective is shaped both by my clinical training and by my own experiences growing up in rural Michigan, navigating foster care and housing instability, and later pursuing my education and publishing a poetry book.
(231) 580-8482 View (231) 580-8482
Photo of Ericka E Hofmeyer, Marriage & Family Therapist, PhD, LMFT
Ericka E Hofmeyer
Marriage & Family Therapist, PhD, LMFT
Online Only
Licensed in CA, FL, MI, DE, NV, SC and UT. Psychotherapy is a journey of discovery. It is a walk toward the self. The purpose of psychotherapy is to assist the patient with knowing the Self: their intrinsic goodness, wisdom and strength found within. For patients, this requires a setting aside of assumptions about the self and others in order for curiosity to emerge. In psychotherapy, we explore what brings meaning to life and what creates value. We ask, “Do my actions bring me closer to the person I want to be?” As I assist the patient with shoring up coping skills we also explore the wondrous road back to the Self.
Licensed in CA, FL, MI, DE, NV, SC and UT. Psychotherapy is a journey of discovery. It is a walk toward the self. The purpose of psychotherapy is to assist the patient with knowing the Self: their intrinsic goodness, wisdom and strength found within. For patients, this requires a setting aside of assumptions about the self and others in order for curiosity to emerge. In psychotherapy, we explore what brings meaning to life and what creates value. We ask, “Do my actions bring me closer to the person I want to be?” As I assist the patient with shoring up coping skills we also explore the wondrous road back to the Self.
(310) 692-9360 View (310) 692-9360
Photo of Nick Zielke, Clinical Social Work/Therapist, LMSW, WPATH, NASW
Nick Zielke
Clinical Social Work/Therapist, LMSW, WPATH, NASW
Online Only
Not accepting new clients
Specialized in Gender, Anxiety and Depression, working with individuals and their loved ones who seek support in navigating challenges presented. I work with clients dealing with Bullying, Oppression, Depression, Anxiety, & Suicidal Ideation. I utilize a combination of Strengths-Based Perspective and Mindfulness Based Approach during Cognitive Behavior Therapy (CBT). I follow the World Professional Association for Transgender Health (WPATH) and NASW Code of Ethics. I provide clients with a safe-space to come-out to the people who are close to them, providing assistance and guidance.
Specialized in Gender, Anxiety and Depression, working with individuals and their loved ones who seek support in navigating challenges presented. I work with clients dealing with Bullying, Oppression, Depression, Anxiety, & Suicidal Ideation. I utilize a combination of Strengths-Based Perspective and Mindfulness Based Approach during Cognitive Behavior Therapy (CBT). I follow the World Professional Association for Transgender Health (WPATH) and NASW Code of Ethics. I provide clients with a safe-space to come-out to the people who are close to them, providing assistance and guidance.
(947) 300-5103 View (947) 300-5103
Photo of Elizabeth Novak, Clinical Social Work/Therapist, LMSW
Elizabeth Novak
Clinical Social Work/Therapist, LMSW
2 Endorsed
Online Only
Throughout my career I've provided support & counseling to highly diverse students, faculty, and staff at a large university, in a large health care system, for a domestic violence center, and currently through virtual individual therapy. From growing up in a small town with a deep love for family and appreciation for nature to raising my own family and continuing my own personal journey, it has been my passion to support healthy self-development, secure and safe relationships, adjustment to life challenges, and optimal well-being.
Throughout my career I've provided support & counseling to highly diverse students, faculty, and staff at a large university, in a large health care system, for a domestic violence center, and currently through virtual individual therapy. From growing up in a small town with a deep love for family and appreciation for nature to raising my own family and continuing my own personal journey, it has been my passion to support healthy self-development, secure and safe relationships, adjustment to life challenges, and optimal well-being.
(616) 312-2122 View (616) 312-2122
Photo of Mackenzie Meredith, Clinical Social Work/Therapist, LLMSW
Mackenzie Meredith
Clinical Social Work/Therapist, LLMSW
2 Endorsed
Grand Rapids, MI 49525
Feelings of anxiety, depression, and stress can be extremely difficult to cope with and overcome. I am here to provide a listening ear and to help you manage these feelings by providing a safe and comfortable space to share, navigate, and explore your thoughts and experiences. My goal is to help you move forward in making positive changes in your life. I provide a client-centered, strengths based, and trauma informed approach with each client.
Feelings of anxiety, depression, and stress can be extremely difficult to cope with and overcome. I am here to provide a listening ear and to help you manage these feelings by providing a safe and comfortable space to share, navigate, and explore your thoughts and experiences. My goal is to help you move forward in making positive changes in your life. I provide a client-centered, strengths based, and trauma informed approach with each client.
(616) 441-4639 View (616) 441-4639
Photo of Emily Hawley, Clinical Social Work/Therapist, LMSW
Emily Hawley
Clinical Social Work/Therapist, LMSW
1 Endorsed
Grand Rapids, MI 49544
Emily works with individuals and families to address concerns including anxiety, depression, grief/loss, attachment, trauma, and adjustment concerns. She provides a safe environment where clients can process their experiences through conversation, play, or creative expression.
Emily works with individuals and families to address concerns including anxiety, depression, grief/loss, attachment, trauma, and adjustment concerns. She provides a safe environment where clients can process their experiences through conversation, play, or creative expression.
(616) 727-8841 View (616) 727-8841
Photo of Tasha Ledesma, Clinical Social Work/Therapist, MSW, LMSW
Tasha Ledesma
Clinical Social Work/Therapist, MSW, LMSW
Grand Rapids, MI 49505
Are you feeling stuck, overwhelmed, or uncertain about your next step? I’m here to help. As a Licensed Clinical Social Worker with 20 years of experience supporting individuals, and families, I offer a safe, nonjudgmental space where you can explore your challenges, reconnect with your strengths, and work toward lasting change.
Are you feeling stuck, overwhelmed, or uncertain about your next step? I’m here to help. As a Licensed Clinical Social Worker with 20 years of experience supporting individuals, and families, I offer a safe, nonjudgmental space where you can explore your challenges, reconnect with your strengths, and work toward lasting change.
(616) 737-0190 View (616) 737-0190

How does your Therapist compare?

Number of Therapists in Howard City, MI

< 10

Therapists in Howard City, MI who prioritize treating:

88% Depression
88% Anxiety
63% Stress
63% Marriage Counseling
50% Relationship Issues
50% ADHD
50% Trauma and PTSD

Average years in practice

14 Years

Top 3 insurances accepted

75% BlueCross and BlueShield
63% Aetna
63% Priority Health

How Therapists in Howard City, MI see their clients

88% In Person and Online
12% Online Only

Gender breakdown

88% Female
12% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Howard 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.