Therapists in Ladue, MO

Photo of Jane N Rubin, Licensed Professional Counselor, MEd, LPC, NCC
Jane N Rubin
Licensed Professional Counselor, MEd, LPC, NCC
1 Endorsed
Ladue, MO 63124
I believe "the right" therapeutic relationship is the key to successful therapy. My approach focuses on creating a safe and empathetic space that is both collaborative and client-centered. I provide specialized therapy to individuals, couples, and families seeking to improve their emotional and mental health, relationships, and overall life experience. I utilize Attachment, Relational, and Interpersonal Theories, Cognitive Behavioral Therapy (CBT), to help identify and change negative thought patterns, and Solution-Focused Therapy (SFBT) to help identify practical strategies to achieve goals.
I believe "the right" therapeutic relationship is the key to successful therapy. My approach focuses on creating a safe and empathetic space that is both collaborative and client-centered. I provide specialized therapy to individuals, couples, and families seeking to improve their emotional and mental health, relationships, and overall life experience. I utilize Attachment, Relational, and Interpersonal Theories, Cognitive Behavioral Therapy (CBT), to help identify and change negative thought patterns, and Solution-Focused Therapy (SFBT) to help identify practical strategies to achieve goals.
(314) 649-5656 View (314) 649-5656
Photo of Katherine Fezzi, Pre-Licensed Professional, MSW, LMSW
Katherine Fezzi
Pre-Licensed Professional, MSW, LMSW
Ladue, MO 63124
Katherine Fezzi is a LMSW with a focused practice in addiction recovery and co-occurring mental health conditions. With a warm, pragmatic, and client-centered approach, Katherine supports individuals and families navigating the complex challenges of substance use, emotional distress, and interpersonal conflict. Those experiences offer deep insight into the personal and systemic stressors people face—especially when emotional and behavioral health issues intersect.
Katherine Fezzi is a LMSW with a focused practice in addiction recovery and co-occurring mental health conditions. With a warm, pragmatic, and client-centered approach, Katherine supports individuals and families navigating the complex challenges of substance use, emotional distress, and interpersonal conflict. Those experiences offer deep insight into the personal and systemic stressors people face—especially when emotional and behavioral health issues intersect.
(314) 272-4755 View (314) 272-4755
Photo of Rebecca Edwards, Clinical Social Work/Therapist, LCSW
Rebecca Edwards
Clinical Social Work/Therapist, LCSW
Ladue, MO 63124
Are You Running on Empty? Are you exhausted from trying to do everything perfectly, constantly putting others first, or feeling like no matter how much you accomplish it's never quite enough? You're not alone, and you don't have to keep pushing through on your own. I work with high performers, perfectionists, and people-pleasers who are struggling with anxiety, stress, and burnout. My clients are often successful on the outside but feel overwhelmed and depleted on the inside. They're the ones who set impossibly high standards, overthink every decision, avoid failure at all costs, and wonder why they can't seem to catch their breath
Are You Running on Empty? Are you exhausted from trying to do everything perfectly, constantly putting others first, or feeling like no matter how much you accomplish it's never quite enough? You're not alone, and you don't have to keep pushing through on your own. I work with high performers, perfectionists, and people-pleasers who are struggling with anxiety, stress, and burnout. My clients are often successful on the outside but feel overwhelmed and depleted on the inside. They're the ones who set impossibly high standards, overthink every decision, avoid failure at all costs, and wonder why they can't seem to catch their breath
(314) 350-4067 View (314) 350-4067
Photo of Laila Merz, Psychologist, PhD
Laila Merz
Psychologist, PhD
Ladue, MO 63124
I went into the field of psychology because I love helping people transform to the best version of themselves. We all need a safe place to understand ourselves and how we relate to others/self. I often say "We need to be Mindful of our Total-Well Being and that our minds and our bodies are an inter-connected systems. Where the mind goes, so does the man or woman in their actions and body states. We go to the physician for our physical health, so how much healthier would we be if we went to our psychologist for our mental health?" At heart, I am a holistic practitioner and love seeing my clients Thrive.
I went into the field of psychology because I love helping people transform to the best version of themselves. We all need a safe place to understand ourselves and how we relate to others/self. I often say "We need to be Mindful of our Total-Well Being and that our minds and our bodies are an inter-connected systems. Where the mind goes, so does the man or woman in their actions and body states. We go to the physician for our physical health, so how much healthier would we be if we went to our psychologist for our mental health?" At heart, I am a holistic practitioner and love seeing my clients Thrive.
(314) 485-4853 View (314) 485-4853
Photo of Julie Geeting - Julie Geeting Counseling & Coaching, Licensed Professional Counselor, LPC, NBC-HWC
Julie Geeting Counseling & Coaching
Licensed Professional Counselor, LPC, NBC-HWC
Ladue, MO 63124
Stress, Anxiety & Burnout Therapy for Adults. Integrative Care in Kirkwood & St. Louis - Many adults come to therapy with insight into their patterns but struggle to follow through on change when stress is high. Communication breaks down, old habits resurface, and progress feels harder to sustain. My work focuses on helping clients understand how emotional patterns, stress responses, and behavior interact - and how to apply insight in real-life situations where it matters most.
Stress, Anxiety & Burnout Therapy for Adults. Integrative Care in Kirkwood & St. Louis - Many adults come to therapy with insight into their patterns but struggle to follow through on change when stress is high. Communication breaks down, old habits resurface, and progress feels harder to sustain. My work focuses on helping clients understand how emotional patterns, stress responses, and behavior interact - and how to apply insight in real-life situations where it matters most.
(314) 451-5593 View (314) 451-5593
Photo of Emily Kellerman, Clinical Social Work/Therapist
Emily Kellerman
Clinical Social Work/Therapist
Online Only
Are you feeling stuck, overwhelmed, or unsure of your next steps? You're not alone—and you don't have to figure it out on your own. My goal is to create a safe, nonjudgmental space where you feel heard, supported, and empowered. Through active listening, compassion, and authenticity, I help you explore what’s holding you back and work toward meaningful change. I believe you are the expert of your own life. Using a strengths-based, person-centered approach, I support you in reconnecting with your inner resources and building the life you want. Whether you're navigating life transitions, anxiety, relationship issues, or past experien
Are you feeling stuck, overwhelmed, or unsure of your next steps? You're not alone—and you don't have to figure it out on your own. My goal is to create a safe, nonjudgmental space where you feel heard, supported, and empowered. Through active listening, compassion, and authenticity, I help you explore what’s holding you back and work toward meaningful change. I believe you are the expert of your own life. Using a strengths-based, person-centered approach, I support you in reconnecting with your inner resources and building the life you want. Whether you're navigating life transitions, anxiety, relationship issues, or past experien
(617) 693-5087 View (617) 693-5087
Photo of Ashley Bell - Footsteps Counseling, LLC, Licensed Professional Counselor, MA, LPC
Footsteps Counseling, LLC
Licensed Professional Counselor, MA, LPC
1 Endorsed
Online Only
Are you just f-ing exhausted? A car accident left you emotionally paralyzed. An assault shook up your life. A recent medical diagnosis or crisis has you questioning what's next. All the "why" questions are flying through your head and the constant noise drives you nuts. You want things to make sense. You want to feel like yourself again. Most of all, you want to go back in time to the thing that changed your body or your life and do everything in your power to prevent it from happening. The problem is that no one prepared you for this or understands how to help.
Are you just f-ing exhausted? A car accident left you emotionally paralyzed. An assault shook up your life. A recent medical diagnosis or crisis has you questioning what's next. All the "why" questions are flying through your head and the constant noise drives you nuts. You want things to make sense. You want to feel like yourself again. Most of all, you want to go back in time to the thing that changed your body or your life and do everything in your power to prevent it from happening. The problem is that no one prepared you for this or understands how to help.
(314) 916-4603 View (314) 916-4603
Photo of Becca Stengel, Licensed Professional Counselor, MS, LPC
Becca Stengel
Licensed Professional Counselor, MS, LPC
2 Endorsed
Online Only
We’ve all had difficult experiences that bring us to our knees. Experiences that shift the way we see the world, see ourselves, the way we move through life. Sometimes it’s hard to move on from those moments until we’re able to experience them with someone who really understands. I’m really good at finding hope in difficult situations. I am skilled at opening up lines of communication in damaged family relationships. A core feature of my work is helping you work through feelings of shame and worthlessness–I’m particularly good at helping teen boys and girls.
We’ve all had difficult experiences that bring us to our knees. Experiences that shift the way we see the world, see ourselves, the way we move through life. Sometimes it’s hard to move on from those moments until we’re able to experience them with someone who really understands. I’m really good at finding hope in difficult situations. I am skilled at opening up lines of communication in damaged family relationships. A core feature of my work is helping you work through feelings of shame and worthlessness–I’m particularly good at helping teen boys and girls.
(417) 738-5436 View (417) 738-5436
Photo of Alli Gannon, Licensed Professional Counselor, MA, LPC
Alli Gannon
Licensed Professional Counselor, MA, LPC
2 Endorsed
Serves Area
Hi, I’m Alli Gannon! I’m a licensed mental health therapist in St. Louis, Missouri with a passion for helping people live healthy, authentic, and meaningful lives. I specialize in anxiety, relationship conflicts, self-esteem, and trauma.
Hi, I’m Alli Gannon! I’m a licensed mental health therapist in St. Louis, Missouri with a passion for helping people live healthy, authentic, and meaningful lives. I specialize in anxiety, relationship conflicts, self-esteem, and trauma.
(314) 451-7966 View (314) 451-7966
Photo of Sharon Lee, Clinical Social Work/Therapist, MSW, LCSW
Sharon Lee
Clinical Social Work/Therapist, MSW, LCSW
4 Endorsed
Online Only
You're the one everyone counts on, but lately, you feel tired, stuck, or disconnected. You may be juggling family expectations, cultural pressures, or the lasting effects of trauma. You want relief from anxiety, overthinking, and burnout, and you're craving peace that actually lasts. You might speak Mandarin at home, English at work, or feel caught between worlds. You're ready for therapy that feels safe, flexible, and genuinely understands where you're coming from.
You're the one everyone counts on, but lately, you feel tired, stuck, or disconnected. You may be juggling family expectations, cultural pressures, or the lasting effects of trauma. You want relief from anxiety, overthinking, and burnout, and you're craving peace that actually lasts. You might speak Mandarin at home, English at work, or feel caught between worlds. You're ready for therapy that feels safe, flexible, and genuinely understands where you're coming from.
(417) 216-6953 View (417) 216-6953
Photo of Susan S Wolfe, Counselor, MA, LPC, NCC
Susan S Wolfe
Counselor, MA, LPC, NCC
2 Endorsed
Serves Area
Not accepting new clients
I consider it a privilege to come alongside courageous clients in the areas of depression, anxiety, abuse, PTSD, as well as strained & broken relationships. I integrate Christian spirituality with IFS (Internal Family Systems), DBT (Dialectical Behavior Therapy), EMDR, and attachment-based models of psychotherapy. I help clients connect what they "know" about God and living that knowledge out with the goal of a "head-heart" connection. Through this process, clients experience long-lasting healing as they learn to live in the freedom of authenticity.
I consider it a privilege to come alongside courageous clients in the areas of depression, anxiety, abuse, PTSD, as well as strained & broken relationships. I integrate Christian spirituality with IFS (Internal Family Systems), DBT (Dialectical Behavior Therapy), EMDR, and attachment-based models of psychotherapy. I help clients connect what they "know" about God and living that knowledge out with the goal of a "head-heart" connection. Through this process, clients experience long-lasting healing as they learn to live in the freedom of authenticity.
(314) 717-1727 View (314) 717-1727
Photo of Sarah Strohmayer, Licensed Professional Counselor, MA, LPC, NCC
Sarah Strohmayer
Licensed Professional Counselor, MA, LPC, NCC
1 Endorsed
Serves Area
Starting therapy can be anxiety-provoking and scary. You are already making the steps to finding someone to start the process of caring for yourself. I am dedicated to helping you gain control of your life and assist you in making changes to become the person you desire to be. I provide a secure and nurturing environment for you to explore deep into yourself and uncover past experiences or beliefs that could be hindering growth. I work a lot with people who have experienced trauma and understand the importance of the process of working through trauma including teaching relaxation and self-regulation techniques.
Starting therapy can be anxiety-provoking and scary. You are already making the steps to finding someone to start the process of caring for yourself. I am dedicated to helping you gain control of your life and assist you in making changes to become the person you desire to be. I provide a secure and nurturing environment for you to explore deep into yourself and uncover past experiences or beliefs that could be hindering growth. I work a lot with people who have experienced trauma and understand the importance of the process of working through trauma including teaching relaxation and self-regulation techniques.
(314) 667-4023 View (314) 667-4023
Photo of Kim Callaway, Licensed Professional Counselor, MA, LPC, NCC
Kim Callaway
Licensed Professional Counselor, MA, LPC, NCC
4 Endorsed
Serves Area
Is Your Life “On Time”? Many people come into therapy carrying a quiet worry: Am I behind? Behind in relationships. Behind in career. Behind in becoming the person they thought they’d be by now. We don’t talk enough about how timing isn’t just about effort or ambition—it’s about history. The experiences we had growing up quietly shaped the routes we took in early adulthood. Some of those routes led to growth. Others led to detours, mistakes, or painful lessons we didn’t fully understand at the time.
Is Your Life “On Time”? Many people come into therapy carrying a quiet worry: Am I behind? Behind in relationships. Behind in career. Behind in becoming the person they thought they’d be by now. We don’t talk enough about how timing isn’t just about effort or ambition—it’s about history. The experiences we had growing up quietly shaped the routes we took in early adulthood. Some of those routes led to growth. Others led to detours, mistakes, or painful lessons we didn’t fully understand at the time.
(314) 696-6080 View (314) 696-6080
Photo of Durre S Mumtaz, Licensed Professional Counselor, MA, LPC
Durre S Mumtaz
Licensed Professional Counselor, MA, LPC
1 Endorsed
Serves Area
In this lifetime, it is inevitable to face difficult times, endure challenges, conflicts, and difficult pursuits, I believe that everyone needs validation, healthy coping mechanisms, and an outlet to improve their emotions thought processes, and live a positive constructive daily life.
In this lifetime, it is inevitable to face difficult times, endure challenges, conflicts, and difficult pursuits, I believe that everyone needs validation, healthy coping mechanisms, and an outlet to improve their emotions thought processes, and live a positive constructive daily life.
(636) 242-8165 View (636) 242-8165
Photo of Jennifer Van Luven - West County Behavioral Health & Psychiatry, Clinical Social Work/Therapist, MSW, LCSW, CM
West County Behavioral Health & Psychiatry
Clinical Social Work/Therapist, MSW, LCSW, CM
Serves Area
West County Behavioral Health offers comprehensive mental health services in a centrally located, welcoming Setting. Located off Olive Blvd (near 270 and 141), we are easily accessible from both St. Louis and St. Charles counties. Our therapists are well known as top-tier clinicians within the St. Louis metro area, and have exceptional reputations in the therapy community.
West County Behavioral Health offers comprehensive mental health services in a centrally located, welcoming Setting. Located off Olive Blvd (near 270 and 141), we are easily accessible from both St. Louis and St. Charles counties. Our therapists are well known as top-tier clinicians within the St. Louis metro area, and have exceptional reputations in the therapy community.
(314) 626-8533 View (314) 626-8533
Photo of Haley Dirkes-Jacks, Licensed Master Social Worker, LMSW
Haley Dirkes-Jacks
Licensed Master Social Worker, LMSW
3 Endorsed
Serves Area
You may be seeking therapy because of changes in behavior, challenges with mental or emotional health, relationship conflicts, school or work stress, or major life transitions. Perhaps you want to better understand your own patterns, explore the systems that shape your life, and identify areas for growth and healing. You may be hoping to deepen your self-awareness, or to better understand your child, and to build healthier, more meaningful connections with those around you.
You may be seeking therapy because of changes in behavior, challenges with mental or emotional health, relationship conflicts, school or work stress, or major life transitions. Perhaps you want to better understand your own patterns, explore the systems that shape your life, and identify areas for growth and healing. You may be hoping to deepen your self-awareness, or to better understand your child, and to build healthier, more meaningful connections with those around you.
(314) 528-9418 View (314) 528-9418
Emma Grady-Pawl
Pre-Licensed Professional, LMSW, MSW
Serves Area
I believe everyone deserves the chance to live a full, joyful life—even when facing hard challenges or systemic barriers. Maybe you’re overwhelmed by stress, navigating a major change, or managing the daily realities of chronic illness or pain. Maybe you’re a high-achieving woman who looks “fine” on the outside but feels weighed down by anxiety, self-criticism, or perfectionism. Whatever you’re carrying, you don’t have to do it alone. I help people find relief, clarity, and compassion for themselves—especially those who feel unseen or misunderstood.
I believe everyone deserves the chance to live a full, joyful life—even when facing hard challenges or systemic barriers. Maybe you’re overwhelmed by stress, navigating a major change, or managing the daily realities of chronic illness or pain. Maybe you’re a high-achieving woman who looks “fine” on the outside but feels weighed down by anxiety, self-criticism, or perfectionism. Whatever you’re carrying, you don’t have to do it alone. I help people find relief, clarity, and compassion for themselves—especially those who feel unseen or misunderstood.
(314) 710-3265 View (314) 710-3265
Photo of Erica Shick, Licensed Professional Counselor, PhD, LCPC, NCC
Erica Shick
Licensed Professional Counselor, PhD, LCPC, NCC
2 Endorsed
Serves Area
You look like you have it together—but you’re tired of carrying so much alone. You overthink, over-give, and hold yourself to standards you’d never expect from anyone else. On the outside you’re capable and composed; on the inside you may feel anxious, disconnected, or stuck in patterns that no longer serve you. Somewhere along the way, being “good,” helpful, or perfect felt necessary. In therapy, we gently untangle those patterns so you can feel grounded, self-trusting, and confident—able to set boundaries and show up fully in your life without guilt or self-doubt.
You look like you have it together—but you’re tired of carrying so much alone. You overthink, over-give, and hold yourself to standards you’d never expect from anyone else. On the outside you’re capable and composed; on the inside you may feel anxious, disconnected, or stuck in patterns that no longer serve you. Somewhere along the way, being “good,” helpful, or perfect felt necessary. In therapy, we gently untangle those patterns so you can feel grounded, self-trusting, and confident—able to set boundaries and show up fully in your life without guilt or self-doubt.
(314) 789-7254 View (314) 789-7254
Photo of Patricia Ann Heiser - Heiser Counseling and Healing Arts, Licensed Professional Counselor, ATR, LPC
Heiser Counseling and Healing Arts
Licensed Professional Counselor, ATR, LPC
2 Endorsed
Serves Area
I am currently offering evening and Saturday hours. I enjoy helping people increase self-awareness, heal and improve their life and relationships. I use a variety of approaches, including client centered, strength based, focused on goals set by each client. I work with Individuals, Couples using EMDR, Intimacy from the Inside-Out, dealing with PTSD, trauma, anxiety, attachments issues, relationships, addictions, and mortality. I enjoy working with individuals, partners, couples and families. I believe in the power of focused healing, increased awareness, compassion, hope and love.
I am currently offering evening and Saturday hours. I enjoy helping people increase self-awareness, heal and improve their life and relationships. I use a variety of approaches, including client centered, strength based, focused on goals set by each client. I work with Individuals, Couples using EMDR, Intimacy from the Inside-Out, dealing with PTSD, trauma, anxiety, attachments issues, relationships, addictions, and mortality. I enjoy working with individuals, partners, couples and families. I believe in the power of focused healing, increased awareness, compassion, hope and love.
(314) 947-5556 View (314) 947-5556
Photo of Amy G Rauscher, Licensed Professional Counselor, LPC, CRC
Amy G Rauscher
Licensed Professional Counselor, LPC, CRC
Serves Area
You're ready to enact real change in your life and just need the help to make it happen. Or you're experiencing major life changes and need support getting through it. With trust and mutual respect we will find common ground to help you feel secure in sharing your struggles and fears. I use a strengths-based perspective to help clients recognize their unique potential and identify changes in their control. I possess unique abilities to connect and engage all age levels and partner with clients ages 14+.
You're ready to enact real change in your life and just need the help to make it happen. Or you're experiencing major life changes and need support getting through it. With trust and mutual respect we will find common ground to help you feel secure in sharing your struggles and fears. I use a strengths-based perspective to help clients recognize their unique potential and identify changes in their control. I possess unique abilities to connect and engage all age levels and partner with clients ages 14+.
(314) 748-1371 View (314) 748-1371

See more therapy options for Ladue

How does your Therapist compare?

Number of Therapists in Ladue, MO

100+

Average cost per session

$150

Therapists in Ladue, MO who prioritize treating:

95% Anxiety
86% Depression
82% Relationship Issues
76% Self Esteem
70% Stress
66% Grief
66% Trauma and PTSD

Average years in practice

13 Years

Top 3 insurances accepted

76% Aetna
60% UnitedHealthcare UHC | UBH
54% Cigna and Evernorth

How Therapists in Ladue, MO see their clients

79% In Person and Online
21% Online Only

Gender breakdown

88% Female
11% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Ladue?

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.