Therapists in Charlestown, NH

Photo of Bridget Buchko, Licensed Clinical Mental Health Counselor, MS, CMHC
Bridget Buchko
Licensed Clinical Mental Health Counselor, MS, CMHC
Online Only
I invite you to be brave and take some time to focus on yourself and your goals. Counseling can be a wonderful bridge in helping us work towards living lives with more contentment, ease, and intentionality. I aim to provide a safe counseling environment that is focused on sharing warmth, humor, authenticity, deep listening, and empathy with others. I deeply believe in the potential that each of us has to make meaningful changes and work towards that which feels important to us. We will work together to explore the challenges you may be facing at this time and develop effective strategies that can make daily life easier.
I invite you to be brave and take some time to focus on yourself and your goals. Counseling can be a wonderful bridge in helping us work towards living lives with more contentment, ease, and intentionality. I aim to provide a safe counseling environment that is focused on sharing warmth, humor, authenticity, deep listening, and empathy with others. I deeply believe in the potential that each of us has to make meaningful changes and work towards that which feels important to us. We will work together to explore the challenges you may be facing at this time and develop effective strategies that can make daily life easier.
(603) 691-1697 View (603) 691-1697
Photo of Crissy Webster - Crissy Webster Counseling Services LLC, Counselor, MA, LCMHC, NCC
Crissy Webster Counseling Services LLC
Counselor, MA, LCMHC, NCC
1 Endorsed
Serves Area
Crissy Webster Counseling Services LLC is a small private practice with two locations, one in Springfield, VT and one in St. Petersburg, FL. We hold licensure in the states of VT, NH, ME, CT, and FL. We see clients of all ages. We have a specialty in Juvenile Firesetting Assessments and Treatment, CISM, as well as, adult and adolescent anger management. Through our collective education and experience, we have extensive knowledge in the areas of Family Systems Model, Trauma Informed Education Practices, ARC, HNC, Parent Training, and we provide various other mental health / psychoeducational evaluations.
Crissy Webster Counseling Services LLC is a small private practice with two locations, one in Springfield, VT and one in St. Petersburg, FL. We hold licensure in the states of VT, NH, ME, CT, and FL. We see clients of all ages. We have a specialty in Juvenile Firesetting Assessments and Treatment, CISM, as well as, adult and adolescent anger management. Through our collective education and experience, we have extensive knowledge in the areas of Family Systems Model, Trauma Informed Education Practices, ARC, HNC, Parent Training, and we provide various other mental health / psychoeducational evaluations.
(802) 952-8671 View (802) 952-8671
Photo of Steven Librot - Northern Lights Counseling: Steven Librot, Counselor, MA, LCMHC
Northern Lights Counseling: Steven Librot
Counselor, MA, LCMHC
Serves Area
Trained and experienced in Sensorimotor Psychotherapy and Internal Family Systems, I offer counseling to adults, teens, and families that combines strength-based approaches which respect each client's unique history and growth process. I work together with each client to develop treatment goals which reflect that client's hopes and dreams. Client goals may include personal growth, less conflict and more rewarding relationship, family, or work experiences, and release from the haunting effects of the past. For teens and young adults, facilitating the learning of safer alternatives than high-risk behaviors, and a stable satisfying journey towards independence and adulthood.
Trained and experienced in Sensorimotor Psychotherapy and Internal Family Systems, I offer counseling to adults, teens, and families that combines strength-based approaches which respect each client's unique history and growth process. I work together with each client to develop treatment goals which reflect that client's hopes and dreams. Client goals may include personal growth, less conflict and more rewarding relationship, family, or work experiences, and release from the haunting effects of the past. For teens and young adults, facilitating the learning of safer alternatives than high-risk behaviors, and a stable satisfying journey towards independence and adulthood.
(802) 392-9954 View (802) 392-9954

More Therapists Nearby

Photo of Rachel Morin, Mental Health Counselor, MA, LCMHC
Rachel Morin
Mental Health Counselor, MA, LCMHC
3 Endorsed
Online Only
Are you struggling with thoughts of "what if" and worst-case scenarios? Do you wish you could get out of your head and focus on the things that are important to you? My patients often struggle with perfectionism, constant worry, anxiety attacks, panic attacks, getting stuck on specific thoughts, or nervous habits like skin or hair pulling/picking. If you are feeling unfulfilled, making choices based on fears and not your values, I can help build your coping skills, challenge your fears, and improve your self-confidence, empowering you to live the life you want.
Are you struggling with thoughts of "what if" and worst-case scenarios? Do you wish you could get out of your head and focus on the things that are important to you? My patients often struggle with perfectionism, constant worry, anxiety attacks, panic attacks, getting stuck on specific thoughts, or nervous habits like skin or hair pulling/picking. If you are feeling unfulfilled, making choices based on fears and not your values, I can help build your coping skills, challenge your fears, and improve your self-confidence, empowering you to live the life you want.
(866) 764-5023 View (866) 764-5023
Photo of Jamie Pouliot, Counselor, MS, LCMHC
Jamie Pouliot
Counselor, MS, LCMHC
1 Endorsed
Swanzey, NH 03446
Not accepting new clients
You might feel like you’ve tried everything, but the same struggles keep showing up. Maybe you’re carrying pain from the past, feeling anxious or disconnected, or just sensing that something inside you needs healing. You may be functioning well on the outside but still feel unsettled or stuck on the inside. What you want most is relief, peace of mind, emotional balance, and a deeper sense of connection to yourself and others.
You might feel like you’ve tried everything, but the same struggles keep showing up. Maybe you’re carrying pain from the past, feeling anxious or disconnected, or just sensing that something inside you needs healing. You may be functioning well on the outside but still feel unsettled or stuck on the inside. What you want most is relief, peace of mind, emotional balance, and a deeper sense of connection to yourself and others.
(603) 352-7300 View (603) 352-7300
Theresa McCafferty
Counselor, PhD, LCMHC, DCCMHC
Keene, NH 03431
The Dr, McCafferty provides a safe and structured environment for children, women, and men to embark on a new personal path to discover self through service and education to help create lives free from the grip of uncontrolled mental health issues and or substance misuse issues.
The Dr, McCafferty provides a safe and structured environment for children, women, and men to embark on a new personal path to discover self through service and education to help create lives free from the grip of uncontrolled mental health issues and or substance misuse issues.
(866) 945-9996 View (866) 945-9996
Photo of Christopher Hinds, Clinical Social Work/Therapist, LICSW, ACSW
Christopher Hinds
Clinical Social Work/Therapist, LICSW, ACSW
Serves Area
I am a firm, sensitive and client-focused therapist with many years of experience helping young people and adults from all types of backgrounds throughout the Northeast and Southeast. I received my MSW from Boston University, with advanced clinical training at the Yale University School of Medicine; where I was selected to work as a Family Therapist at the Yale Psychiatric Institute; a pre-eminent teaching hospital; when I was 32. I help clients with individual, family and/or marital and relationship issues, mental health and serious mounting chemical dependency problems.
I am a firm, sensitive and client-focused therapist with many years of experience helping young people and adults from all types of backgrounds throughout the Northeast and Southeast. I received my MSW from Boston University, with advanced clinical training at the Yale University School of Medicine; where I was selected to work as a Family Therapist at the Yale Psychiatric Institute; a pre-eminent teaching hospital; when I was 32. I help clients with individual, family and/or marital and relationship issues, mental health and serious mounting chemical dependency problems.
(802) 644-3688 View (802) 644-3688
Photo of Anna Weigle, Counselor, LCMHC
Anna Weigle
Counselor, LCMHC
Keene, NH 03431
Not accepting new clients
Many people describe a painful sense of weariness with trying to change their patterns with the current skills that they have. Working towards personal change takes hard work, and I am looking forward to taking this journey with you. Change takes a leap of faith in trying new ways of thinking and being. Working together, you will learn new ways to approach your symptoms and develop skills that you can use in everyday life.
Many people describe a painful sense of weariness with trying to change their patterns with the current skills that they have. Working towards personal change takes hard work, and I am looking forward to taking this journey with you. Change takes a leap of faith in trying new ways of thinking and being. Working together, you will learn new ways to approach your symptoms and develop skills that you can use in everyday life.
(888) 893-2979 View (888) 893-2979
Photo of Lara Pirro Jancetic, Marriage & Family Therapist, MA, LMFT
Lara Pirro Jancetic
Marriage & Family Therapist, MA, LMFT
Grantham, NH 03753
Not accepting new clients
I offer a focused biopsychosocial approach on each individual, couple or a family's presenting concern or desire for treatment. I place attention on medical as well as psychological concerns as I see them to be interconnected. I work with a systemic understanding of the individual. That is, I understand the individual to be a part of a system of relationships that includes family members, partners, colleagues, their social connections, culture and spiritual or faith-based practices. I studied meditation and mindfulness and apply them to my practice when applicable.
I offer a focused biopsychosocial approach on each individual, couple or a family's presenting concern or desire for treatment. I place attention on medical as well as psychological concerns as I see them to be interconnected. I work with a systemic understanding of the individual. That is, I understand the individual to be a part of a system of relationships that includes family members, partners, colleagues, their social connections, culture and spiritual or faith-based practices. I studied meditation and mindfulness and apply them to my practice when applicable.
(603) 606-9257 View (603) 606-9257
Photo of Kim Burden - Kim Burden, LCMHC, Counselor, MA, LCMHC, LCAT, BC-DMT, RDT/BCT
Kim Burden, LCMHC
Counselor, MA, LCMHC, LCAT, BC-DMT, RDT/BCT
Keene, NH 03431
Please note that I am unable to accept new clients at this time. I've been providing creative, collaborative, practical counseling for adults and adolescents, with a down to earth, compassionate approach, for 22 years. Focusing on the wisdom within body, mind and spirit, I support people to think, feel and act creatively, find balance, and honor their natural strengths. I integrate dance/movement therapy, drama therapy, expressive arts and Yoga in my work. Areas of focus include life transitions, LGBTQ concerns, women's issues, social justice focus, and spirituality.
Please note that I am unable to accept new clients at this time. I've been providing creative, collaborative, practical counseling for adults and adolescents, with a down to earth, compassionate approach, for 22 years. Focusing on the wisdom within body, mind and spirit, I support people to think, feel and act creatively, find balance, and honor their natural strengths. I integrate dance/movement therapy, drama therapy, expressive arts and Yoga in my work. Areas of focus include life transitions, LGBTQ concerns, women's issues, social justice focus, and spirituality.
(603) 244-3325 View (603) 244-3325
Photo of Max Foldeak, Counselor, MA, LCMHC
Max Foldeak
Counselor, MA, LCMHC
Serves Area
Waitlist for new clients
I have been working as a psychotherapist, counselor, clinical supervisor and consultant for over twenty years. My approach has become eclectic and energized by my interest in family systems, substance use, emotional well being, and the possibilities offered by an in depth approach to psychotherapy. My training as an Archetypal Pattern Analyst and in orientational approaches to dream work have consistently informed my work and my enjoyment of the psychotherapeutic and consulting process. The more I learn the more respect, empathy, joy and humor I have for the act of collaboration needed to find a fuller way of being in our lives.
I have been working as a psychotherapist, counselor, clinical supervisor and consultant for over twenty years. My approach has become eclectic and energized by my interest in family systems, substance use, emotional well being, and the possibilities offered by an in depth approach to psychotherapy. My training as an Archetypal Pattern Analyst and in orientational approaches to dream work have consistently informed my work and my enjoyment of the psychotherapeutic and consulting process. The more I learn the more respect, empathy, joy and humor I have for the act of collaboration needed to find a fuller way of being in our lives.
(802) 732-2569 View (802) 732-2569
Photo of Todd Lindsley, Psychologist, PhD
Todd Lindsley
Psychologist, PhD
Online Only
You came to this site because something isn't working and you may be out of ideas on how to make things better. You might have anxiety, relationship struggles, identity issues, or just know that something doesn't feel right. I draw on my Ph.D. in Psychology and Master's degree in Marriage and Family Therapy, along with years of experience helping to understand what the problem might be and working with you toward achieving the life you desire. My clients bring a willingness to explore and an openness to change.
You came to this site because something isn't working and you may be out of ideas on how to make things better. You might have anxiety, relationship struggles, identity issues, or just know that something doesn't feel right. I draw on my Ph.D. in Psychology and Master's degree in Marriage and Family Therapy, along with years of experience helping to understand what the problem might be and working with you toward achieving the life you desire. My clients bring a willingness to explore and an openness to change.
(603) 836-8952 View (603) 836-8952
Photo of Kate Turcotte, Pre-Licensed Professional, MSW, SW
Kate Turcotte
Pre-Licensed Professional, MSW, SW
New London, NH 03257
As a clinical social worker, Kate draws upon her sociological training in the therapeutic setting through extensive use of a person-in-environment context as well as strengths-based and client-centered approaches to guide individuals in developing and working toward their goals such as anxiety and stress reduction, life satisfaction and resilience in the context of significant life changes, and increased levels of agency. She also maintains an active research and therapeutic interest in working with survivors of domestic and family violence.
As a clinical social worker, Kate draws upon her sociological training in the therapeutic setting through extensive use of a person-in-environment context as well as strengths-based and client-centered approaches to guide individuals in developing and working toward their goals such as anxiety and stress reduction, life satisfaction and resilience in the context of significant life changes, and increased levels of agency. She also maintains an active research and therapeutic interest in working with survivors of domestic and family violence.
(844) 385-9904 View (844) 385-9904
Photo of Alexandria Brunkow, Psychologist, PhD
Alexandria Brunkow
Psychologist, PhD
Serves Area
Are you overwhelmed by chronic illness? Is pain, fatigue, or disrupted sleep making it difficult to function? Are you undergoing cancer treatment or recovery and struggling to cope emotionally? Physical health challenges can be profoundly isolating, but you don't have to face them alone. As a health psychologist, I can help you navigate the intersection of physical and mental health. You can build skills to manage stress, enhance sleep quality, and restore emotional balance. Therapy offers a space to learn about yourself, build resilience, and move forward with greater confidence. I look forward to hearing your story.
Are you overwhelmed by chronic illness? Is pain, fatigue, or disrupted sleep making it difficult to function? Are you undergoing cancer treatment or recovery and struggling to cope emotionally? Physical health challenges can be profoundly isolating, but you don't have to face them alone. As a health psychologist, I can help you navigate the intersection of physical and mental health. You can build skills to manage stress, enhance sleep quality, and restore emotional balance. Therapy offers a space to learn about yourself, build resilience, and move forward with greater confidence. I look forward to hearing your story.
(877) 696-9808 View (877) 696-9808
Photo of Stephanie Lewis, Counselor, LCMHC
Stephanie Lewis
Counselor, LCMHC
1 Endorsed
Online Only
Specialized training in Dialectical Behavioral Therapy (DBT), serving adolescents and families, having participated and co-facilitated mindfulness and distress tolerance group sessions. A true believer that individuals are doing the best they can, and they can do better. Focusing on one's strengths enables an individual to pull upon the characteristics and skills they already possess, serving them for the better, creating a mindset of strength, faith and hope.
Specialized training in Dialectical Behavioral Therapy (DBT), serving adolescents and families, having participated and co-facilitated mindfulness and distress tolerance group sessions. A true believer that individuals are doing the best they can, and they can do better. Focusing on one's strengths enables an individual to pull upon the characteristics and skills they already possess, serving them for the better, creating a mindset of strength, faith and hope.
(603) 367-3382 View (603) 367-3382
Photo of Austin Mabry, Clinical Mental Health Counselor Candidate, CMHC
Austin Mabry
Clinical Mental Health Counselor Candidate, CMHC
1 Endorsed
Keene, NH 03431
I specialize in working with young men and boys. For many boys and young men, depression and anxiety can look like anger, communication issues, trouble in school, substance use, or a general disconnection from feelings. For some, therapy would be their last choice for how they would like to spend their time. It is not expected that you will open up right away. I follow the pace of my clients and begin with building connection and trust. That could look like playing games together, going for a walk, telling jokes, or sitting together without much to say.
I specialize in working with young men and boys. For many boys and young men, depression and anxiety can look like anger, communication issues, trouble in school, substance use, or a general disconnection from feelings. For some, therapy would be their last choice for how they would like to spend their time. It is not expected that you will open up right away. I follow the pace of my clients and begin with building connection and trust. That could look like playing games together, going for a walk, telling jokes, or sitting together without much to say.
(603) 283-5112 View (603) 283-5112
Photo of Bill Warriner, Counselor, LCMHC, LADC, MDiv
Bill Warriner
Counselor, LCMHC, LADC, MDiv
Serves Area
I usually find that clients managing anxiety, depression, loss and/or addiction are first looking for a compassionate listener with the experience and knowledge that facilitates emerging inner strength. My approach is compassionate, non-judgmental and professional. Frequently my clients have issues with drugs or alcohol and I may work also with their partners, family, or concerned friends. I feel it is critical for everyone involved to know that they are not alone in their struggles, that support and guidance are available and that therapy has helped people feel better than they thought possible.
I usually find that clients managing anxiety, depression, loss and/or addiction are first looking for a compassionate listener with the experience and knowledge that facilitates emerging inner strength. My approach is compassionate, non-judgmental and professional. Frequently my clients have issues with drugs or alcohol and I may work also with their partners, family, or concerned friends. I feel it is critical for everyone involved to know that they are not alone in their struggles, that support and guidance are available and that therapy has helped people feel better than they thought possible.
(802) 392-4165 View (802) 392-4165
Photo of Madison Fowler, Pre-Licensed Professional
Madison Fowler
Pre-Licensed Professional
Lebanon, NH 03766
I am a counselor-in-training at Northwestern University, working toward my licensure as a clinical mental health counselor (LCMHC). I work with adults who are experiencing challenges in their daily life that may be impacting overall well-being, including anxiety, depression, relationship challenges, and life transitions. I also work with children and adolescents who may be experiencing challenges with anxiety, adjustment, social functioning, and emotional regulation.
I am a counselor-in-training at Northwestern University, working toward my licensure as a clinical mental health counselor (LCMHC). I work with adults who are experiencing challenges in their daily life that may be impacting overall well-being, including anxiety, depression, relationship challenges, and life transitions. I also work with children and adolescents who may be experiencing challenges with anxiety, adjustment, social functioning, and emotional regulation.
(833) 317-4092 View (833) 317-4092
Photo of Mary Cleary Lewis - Dr. Mary Cleary Lewis, Licensed Psychoanalyst, MA, PsyaD, CAGS
Dr. Mary Cleary Lewis
Licensed Psychoanalyst, MA, PsyaD, CAGS
Serves Area
I am a psychoanalytically trained psychotherapist whose primary focus is on developing a relationship of trust between therapist and client that is essential to the healing process. I put a strong emphasis on the importance of the client's comfort in the room both physically and emotionally. Although I encourage my clients to say everything, I also think their instincts regarding when and how much they want to share should be respected. Respecting the boundaries and privacy of my clients is something I regard as the foundation of a good therapeutic relationship.
I am a psychoanalytically trained psychotherapist whose primary focus is on developing a relationship of trust between therapist and client that is essential to the healing process. I put a strong emphasis on the importance of the client's comfort in the room both physically and emotionally. Although I encourage my clients to say everything, I also think their instincts regarding when and how much they want to share should be respected. Respecting the boundaries and privacy of my clients is something I regard as the foundation of a good therapeutic relationship.
(802) 659-4626 View (802) 659-4626
Photo of Alyssa LoGrasso Power, Clinical Social Work/Therapist, MSW, LICSW
Alyssa LoGrasso Power
Clinical Social Work/Therapist, MSW, LICSW
1 Endorsed
New London, NH 03257
I utilize an integrative and holistic approach to therapy, considering the whole person; their mental, emotional, and physical health, relationships, spirituality, and environment. I incorporate modalities such as dialectical behavior therapy, mindfulness, somatic interventions, ecotherapy, nutrition, and more to support clients in feeling more embodied, connected, and empowered to make the changes necessary to improve their well-being. I bring warmth and compassion to each session and offer a collaborative, strengths-based approach. In addition to telehealth therapy, I also offer walk and talk therapy in New London.
I utilize an integrative and holistic approach to therapy, considering the whole person; their mental, emotional, and physical health, relationships, spirituality, and environment. I incorporate modalities such as dialectical behavior therapy, mindfulness, somatic interventions, ecotherapy, nutrition, and more to support clients in feeling more embodied, connected, and empowered to make the changes necessary to improve their well-being. I bring warmth and compassion to each session and offer a collaborative, strengths-based approach. In addition to telehealth therapy, I also offer walk and talk therapy in New London.
(888) 846-7417 View (888) 846-7417

See more therapy options for Charlestown

How does your Therapist compare?

Number of Therapists in Charlestown, NH

< 10

Therapists in Charlestown, NH who prioritize treating:

100% Self Esteem
100% Stress
67% Child
67% Relationship Issues
67% Eating Disorders
67% Depression
67% Personality Disorders

Average years in practice

14 Years

Top 3 insurances accepted

100% Aetna
100% BlueCross and BlueShield
100% Cigna and Evernorth

How Therapists in Charlestown, NH see their clients

67% In Person and Online
33% Online Only

Gender breakdown

67% Female
33% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Charlestown?

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.