Therapists in Howell, NJ

Photo of Kristen Neglia, Licensed Professional Counselor, LPC
Kristen Neglia
Licensed Professional Counselor, LPC
Online Only
My goal is to work collaboratively with the client to provide a place where the client feels safe and open to work through challenges using different tools and techniques. I utilize many therapeutic orientations in order to fit each clients individual needs, as not every technique works the same for each client. My goal is to create a supportive, nonjudgemental, and empathetic safe space for individuals to explore and express themselves. I am committed to working collaboratively with the individual to build on their strengths and assist them in the direction of wellness and healing.
My goal is to work collaboratively with the client to provide a place where the client feels safe and open to work through challenges using different tools and techniques. I utilize many therapeutic orientations in order to fit each clients individual needs, as not every technique works the same for each client. My goal is to create a supportive, nonjudgemental, and empathetic safe space for individuals to explore and express themselves. I am committed to working collaboratively with the individual to build on their strengths and assist them in the direction of wellness and healing.
(848) 305-2369 View (848) 305-2369
Photo of Melissa Jackson, Licensed Professional Counselor, MA, LPC
Melissa Jackson
Licensed Professional Counselor, MA, LPC
1 Endorsed
Online Only
Melissa is a Licensed Professional Counselor who works with individuals, couples, and families. She has over 15 years of experience across a variety of settings including residential, nonprofits, inpatient, corrections and private practice. Melissa is skilled in working with anxiety, depression, ADHD, grief, and relationship issues. Melissa will tailor your treatment to fit your needs by utilizing evidence-based treatments while prioritizing client growth, strength, and trust. Melissa graduated with a Masters in Psychological Counseling from Monmouth University.
Melissa is a Licensed Professional Counselor who works with individuals, couples, and families. She has over 15 years of experience across a variety of settings including residential, nonprofits, inpatient, corrections and private practice. Melissa is skilled in working with anxiety, depression, ADHD, grief, and relationship issues. Melissa will tailor your treatment to fit your needs by utilizing evidence-based treatments while prioritizing client growth, strength, and trust. Melissa graduated with a Masters in Psychological Counseling from Monmouth University.
(848) 292-9617 View (848) 292-9617
Photo of Stephanie L Sullivan, Licensed Professional Counselor, MS, LPC, NCC
Stephanie L Sullivan
Licensed Professional Counselor, MS, LPC, NCC
Howell, NJ 07731
When you have experienced a trauma, developed uncontrollable anxiety, have a child who is overwhelmingly oppositional, or anything in between, it can feel extremely isolating. That is why we are here at Sullivan Counseling Services. No one should ever feel alone when they are going through a difficult time and may need an outside source to help guide them in the right direction. Our goal is to help each person who comes to therapy gain motivation and move in a positive direction to better their current situation.
When you have experienced a trauma, developed uncontrollable anxiety, have a child who is overwhelmingly oppositional, or anything in between, it can feel extremely isolating. That is why we are here at Sullivan Counseling Services. No one should ever feel alone when they are going through a difficult time and may need an outside source to help guide them in the right direction. Our goal is to help each person who comes to therapy gain motivation and move in a positive direction to better their current situation.
(732) 627-2912 View (732) 627-2912
Photo of Jeff Firsichbaum, Clinical Social Work/Therapist, MSW, LCSW, LCADC
Jeff Firsichbaum
Clinical Social Work/Therapist, MSW, LCSW, LCADC
Online Only
As John Lennon wrote "Life is what happens when we're busy making other plans". In addition to re-adjusting to life after the pandemic, the political landscape may also lead to feeling somewhat disconnected from family and friends. Many people continue to experience anxiety, depression and relationship issues as a result. Most of my clients had initial reservations about trying telehealth but, much like everything else lately, we’re resilient and go with the flow. The benefits of telehealth are that you don’t have to travel, scheduling is much easier and you can be seen wherever you have internet (must be in NJ during session).
As John Lennon wrote "Life is what happens when we're busy making other plans". In addition to re-adjusting to life after the pandemic, the political landscape may also lead to feeling somewhat disconnected from family and friends. Many people continue to experience anxiety, depression and relationship issues as a result. Most of my clients had initial reservations about trying telehealth but, much like everything else lately, we’re resilient and go with the flow. The benefits of telehealth are that you don’t have to travel, scheduling is much easier and you can be seen wherever you have internet (must be in NJ during session).
(732) 838-5531 View (732) 838-5531
Photo of Cristina Keresztes, Licensed Professional Counselor, MA, LPC
Cristina Keresztes
Licensed Professional Counselor, MA, LPC
Online Only
I earned my Bachelor’s degree in Psychology from Rutgers University and my Master’s in Counseling Education from Kean University in New Jersey. I am a Licensed Professional Counselor (LPC) with extensive experience working with trauma, children and families, substance use treatment, and partial hospitalization and intensive outpatient programs. I work with adolescents and adults in a collaborative, supportive approach to address concerns such as anxiety, depression, mood and behavioral challenges, life transitions, stress, addiction recovery, family and relationship issues, and trauma.
I earned my Bachelor’s degree in Psychology from Rutgers University and my Master’s in Counseling Education from Kean University in New Jersey. I am a Licensed Professional Counselor (LPC) with extensive experience working with trauma, children and families, substance use treatment, and partial hospitalization and intensive outpatient programs. I work with adolescents and adults in a collaborative, supportive approach to address concerns such as anxiety, depression, mood and behavioral challenges, life transitions, stress, addiction recovery, family and relationship issues, and trauma.
(732) 422-5508 View (732) 422-5508
Photo of Patrice Hegel, Clinical Social Work/Therapist, MSW, LCSW
Patrice Hegel
Clinical Social Work/Therapist, MSW, LCSW
4 Endorsed
Howell, NJ 07731
Waitlist for new clients
Co-founder and partner of Comprehensive Counseling Center, Howell NJ. I've been in practice for 33+ years. My primary focus is couples, marital and adult individual counseling. My role, when a couple or individual seeks out counseling, is to both be able to listen, in a caring non-judgemental way, and be direct when necessary. I work with the client to tailor the treatment to their unique needs; to help with guidance, support and information, so that things can move forward and their goals can be reached. It's a process that works best when we work together, and is done in an atmosphere of respect, confidentiality and safety.
Co-founder and partner of Comprehensive Counseling Center, Howell NJ. I've been in practice for 33+ years. My primary focus is couples, marital and adult individual counseling. My role, when a couple or individual seeks out counseling, is to both be able to listen, in a caring non-judgemental way, and be direct when necessary. I work with the client to tailor the treatment to their unique needs; to help with guidance, support and information, so that things can move forward and their goals can be reached. It's a process that works best when we work together, and is done in an atmosphere of respect, confidentiality and safety.
(732) 982-4395 View (732) 982-4395
Photo of Patricia M Carroll, Licensed Professional Counselor, EdS, NCC, LPC
Patricia M Carroll
Licensed Professional Counselor, EdS, NCC, LPC
3 Endorsed
Howell, NJ 07731
Welcome! My name is Patricia Carroll. I am a Licensed Professional Counselor. Let me tell you a little about myself. I hold an undergraduate degree in psychology & a Master of Arts in Counseling, both from Rider University. I continued my education post-graduate & earned an Education Specialist degree from Rider University. I have worked in a variety of environments, including partial hospitalization programs, crisis intervention centers, care management, utilization management & outpatient psychotherapy settings. I have 10+ years experience working with children, adolescents, adults and families. I welcome you to contact me with any questions and concerns that you might have.
Welcome! My name is Patricia Carroll. I am a Licensed Professional Counselor. Let me tell you a little about myself. I hold an undergraduate degree in psychology & a Master of Arts in Counseling, both from Rider University. I continued my education post-graduate & earned an Education Specialist degree from Rider University. I have worked in a variety of environments, including partial hospitalization programs, crisis intervention centers, care management, utilization management & outpatient psychotherapy settings. I have 10+ years experience working with children, adolescents, adults and families. I welcome you to contact me with any questions and concerns that you might have.
(732) 964-9669 View (732) 964-9669
Photo of Tiffany Campbell, Marriage & Family Therapist, LMFT
Tiffany Campbell
Marriage & Family Therapist, LMFT
2 Endorsed
Online Only
I have been providing therapy to adolescents and adults for over 15 years, helping them navigate life challenges and uncover their strengths. My therapeutic work is rooted in connection, safety, and support. I have experience working with adolescents and adults navigating anxiety, AD/HD, life transitions, relationship/marital issues, depression, family conflict, parenting concerns, and trauma.
I have been providing therapy to adolescents and adults for over 15 years, helping them navigate life challenges and uncover their strengths. My therapeutic work is rooted in connection, safety, and support. I have experience working with adolescents and adults navigating anxiety, AD/HD, life transitions, relationship/marital issues, depression, family conflict, parenting concerns, and trauma.
(908) 430-5665 View (908) 430-5665
Photo of Ashley Del Bene, Clinical Social Work/Therapist, LSW
Ashley Del Bene
Clinical Social Work/Therapist, LSW
Howell, NJ 07731
Ashley M. Del Bene, MSW, LSW is a youth therapist who works with children, adolescents, and young adults. She creates a safe, supportive space where children and teens can explore their emotions, build coping skills, and strengthen social connections in ways that feel natural and empowering. With a warm, strengths-based, and person-centered approach, Ashley blends Cognitive Behavioral Therapy (CBT) and Social-Emotional Learning (SEL) with creative, play-based methods such as art, games, mindfulness, and guided conversations.
Ashley M. Del Bene, MSW, LSW is a youth therapist who works with children, adolescents, and young adults. She creates a safe, supportive space where children and teens can explore their emotions, build coping skills, and strengthen social connections in ways that feel natural and empowering. With a warm, strengths-based, and person-centered approach, Ashley blends Cognitive Behavioral Therapy (CBT) and Social-Emotional Learning (SEL) with creative, play-based methods such as art, games, mindfulness, and guided conversations.
(732) 907-8298 View (732) 907-8298
Photo of Judy Sininsky, Clinical Social Work/Therapist, LCSW
Judy Sininsky
Clinical Social Work/Therapist, LCSW
2 Endorsed
Howell, NJ 07731
I believe meaningful change begins with motivation and support. For over 25 years in private practice, I’ve created a safe, compassionate space where clients feel heard and understood. As Co-founder of Comprehensive Counseling Center (CCC), I’m proud to offer inclusive, confidential, and high-quality counseling through our team of skilled clinicians. We provide individual, couples, family, and group therapy for children, adolescents, and adults. If you’re ready to take the next step toward growth and well-being, I invite you to reach out—together, we can create lasting change.
I believe meaningful change begins with motivation and support. For over 25 years in private practice, I’ve created a safe, compassionate space where clients feel heard and understood. As Co-founder of Comprehensive Counseling Center (CCC), I’m proud to offer inclusive, confidential, and high-quality counseling through our team of skilled clinicians. We provide individual, couples, family, and group therapy for children, adolescents, and adults. If you’re ready to take the next step toward growth and well-being, I invite you to reach out—together, we can create lasting change.
(732) 474-8995 View (732) 474-8995
Photo of Mary Sznyter, Licensed Professional Counselor, MA, LPC
Mary Sznyter
Licensed Professional Counselor, MA, LPC
2 Endorsed
Howell, NJ 07731
Mary Sznyter, MA, LPC, is a Licensed Professional Counselor who has been counseling for 24 years and is in private practice in Howell, NJ. She specializes in adults and families; individual and group therapies. She continued her post-graduate training in Psychodrama and Group Counseling, in addition to on-going training in specific interventions for anxiety, depression and Post-Traumatic Stress Disorder.
Mary Sznyter, MA, LPC, is a Licensed Professional Counselor who has been counseling for 24 years and is in private practice in Howell, NJ. She specializes in adults and families; individual and group therapies. She continued her post-graduate training in Psychodrama and Group Counseling, in addition to on-going training in specific interventions for anxiety, depression and Post-Traumatic Stress Disorder.
(732) 722-5017 View (732) 722-5017
Photo of Scott Silvester, Counselor, LAC
Scott Silvester
Counselor, LAC
Howell, NJ 07731
Scott is a Licensed Associate Counselor in the state of New Jersey and is currently working towards his hours for Licensed Professional Counselor. He received his master’s degree from Rider University in Clinical Mental Health in 2024. Scott has experience working with clients in the treatment of depression, anxiety, and addiction. He enjoys using aspects of Cognitive Behavioral Therapy, Solution-Focused Therapy, Dialectical Behavioral Therapy, and Acceptance and Commitment Therapy. Scott works primarily with clients 18+ and is looking forward to working with couples.
Scott is a Licensed Associate Counselor in the state of New Jersey and is currently working towards his hours for Licensed Professional Counselor. He received his master’s degree from Rider University in Clinical Mental Health in 2024. Scott has experience working with clients in the treatment of depression, anxiety, and addiction. He enjoys using aspects of Cognitive Behavioral Therapy, Solution-Focused Therapy, Dialectical Behavioral Therapy, and Acceptance and Commitment Therapy. Scott works primarily with clients 18+ and is looking forward to working with couples.
(908) 264-5249 View (908) 264-5249
Photo of Jackie Amorelli, Clinical Social Work/Therapist, LCSW
Jackie Amorelli
Clinical Social Work/Therapist, LCSW
1 Endorsed
Online Only
Many of the ways we learned to cope in childhood helped us survive difficult experiences, but those same patterns of coping can create stress, anxiety, relationship struggles and emotional overwhelm in adulthood. I strive to provide a safe space to help clients understand these patterns, connect with yourself, and build skills for navigating life with greater clarity and confidence. Together, we can help you develop healthier, more effective ways of coping so you can experience relief, calm and fulfillment in your life.
Many of the ways we learned to cope in childhood helped us survive difficult experiences, but those same patterns of coping can create stress, anxiety, relationship struggles and emotional overwhelm in adulthood. I strive to provide a safe space to help clients understand these patterns, connect with yourself, and build skills for navigating life with greater clarity and confidence. Together, we can help you develop healthier, more effective ways of coping so you can experience relief, calm and fulfillment in your life.
(908) 309-5891 View (908) 309-5891
Photo of Emily Whille, Licensed Social Worker , LSW
Emily Whille
Licensed Social Worker , LSW
Howell, NJ 07731
Exploring the lived human experience involves acknowledging its diverse challenges, wide range of emotions, and the essential role of healthy relationships. Therapy is a blend of empathy, empowerment, unwavering support, and professional guidance. It provides a constructive framework for individuals to explore, understand, and ultimately embrace their authentic selves. The focus should always be on the client's growth and progress. I take immense pride in my clients' accomplishments, celebrating them as if they were my own.
Exploring the lived human experience involves acknowledging its diverse challenges, wide range of emotions, and the essential role of healthy relationships. Therapy is a blend of empathy, empowerment, unwavering support, and professional guidance. It provides a constructive framework for individuals to explore, understand, and ultimately embrace their authentic selves. The focus should always be on the client's growth and progress. I take immense pride in my clients' accomplishments, celebrating them as if they were my own.
(732) 978-9425 View (732) 978-9425
Photo of Mallory LaCorte, Licensed Professional Counselor, LPC
Mallory LaCorte
Licensed Professional Counselor, LPC
Howell, NJ 07731
I approach therapy by starting with an initial evaluation to understand my client's unique goals. From there, we collaborate to develop a treatment plan tailored to their specific needs. With years of experience working in both hospital and agency settings before transitioning to private practice, I have developed expertise in both group and individual therapy.
I approach therapy by starting with an initial evaluation to understand my client's unique goals. From there, we collaborate to develop a treatment plan tailored to their specific needs. With years of experience working in both hospital and agency settings before transitioning to private practice, I have developed expertise in both group and individual therapy.
(732) 561-5818 View (732) 561-5818
Photo of Judy Carpentier, Clinical Social Work/Therapist, MSW, LCSW, LCADC
Judy Carpentier
Clinical Social Work/Therapist, MSW, LCSW, LCADC
Online Only
Not accepting new clients
How are alcohol or other drugs showing up in your life? Anxiety and depression can be contributing factors and/or consequences. Maybe you're questioning if you have a problem, or you are in early recovery and want support to maintain your sobriety. You might feel discouraged when you break promises to yourself to cut back or stop. Trying to hide your use from family and friends can be exhausting. Sometimes habits turn into patterns that are hard to break despite your best intentions. Unresolved trauma can make recovery challenging.
How are alcohol or other drugs showing up in your life? Anxiety and depression can be contributing factors and/or consequences. Maybe you're questioning if you have a problem, or you are in early recovery and want support to maintain your sobriety. You might feel discouraged when you break promises to yourself to cut back or stop. Trying to hide your use from family and friends can be exhausting. Sometimes habits turn into patterns that are hard to break despite your best intentions. Unresolved trauma can make recovery challenging.
(732) 347-6041 View (732) 347-6041
Photo of Rebecca Sundt, Licensed Social Worker, LSW
Rebecca Sundt
Licensed Social Worker, LSW
Howell, NJ 07731
Rebecca has worked in the mental health field since 2021, gaining experience with clients across a variety of settings, including partial care, intensive outpatient (IOP), and outpatient programs. Motivated by her own personal journey and a deep desire to help others recognize their strengths, Rebecca is passionate about guiding individuals toward becoming the best versions of themselves. She has experience supporting clients living with symptoms of depression, anxiety, ADHD, trauma, grief, self-esteem challenges, social skills difficulties, and substance use.
Rebecca has worked in the mental health field since 2021, gaining experience with clients across a variety of settings, including partial care, intensive outpatient (IOP), and outpatient programs. Motivated by her own personal journey and a deep desire to help others recognize their strengths, Rebecca is passionate about guiding individuals toward becoming the best versions of themselves. She has experience supporting clients living with symptoms of depression, anxiety, ADHD, trauma, grief, self-esteem challenges, social skills difficulties, and substance use.
(848) 358-7104 View (848) 358-7104
Photo of Toni Nokes, Clinical Social Work/Therapist, MSW, LCSW
Toni Nokes
Clinical Social Work/Therapist, MSW, LCSW
6 Endorsed
Howell, NJ 07731
I believe a good fit with a therapist is crucial to successful treatment. The right relationship can facilitate healing right from the start. I work best with those who know why they are seeking counseling and have a desire to feel better and improve their lives. While striving to create a casual and welcoming environment, I tailor the treatment to suit the individual's needs and goals, first and foremost.
I believe a good fit with a therapist is crucial to successful treatment. The right relationship can facilitate healing right from the start. I work best with those who know why they are seeking counseling and have a desire to feel better and improve their lives. While striving to create a casual and welcoming environment, I tailor the treatment to suit the individual's needs and goals, first and foremost.
(732) 333-8164 View (732) 333-8164
Photo of James Joseph Murray, Clinical Social Work/Therapist, LCSW
James Joseph Murray
Clinical Social Work/Therapist, LCSW
Howell, NJ 07731
Helping individuals and families lead more healthy and productive lives.Clinical areas:martial/couples counseling,problems of youth(12yrs and up,SAP evaluations,anxiety/depressive dirorders, post traumatic stress disorder,addiction:substance abuse(alcohol,gambling,sexual addiction.major treament approach is cognative behavioral therapy
Helping individuals and families lead more healthy and productive lives.Clinical areas:martial/couples counseling,problems of youth(12yrs and up,SAP evaluations,anxiety/depressive dirorders, post traumatic stress disorder,addiction:substance abuse(alcohol,gambling,sexual addiction.major treament approach is cognative behavioral therapy
(732) 372-0991 View (732) 372-0991
Photo of Samantha Mandala, Clinical Social Work/Therapist, LCSW, PMH-C, LCADC
Samantha Mandala
Clinical Social Work/Therapist, LCSW, PMH-C, LCADC
2 Endorsed
Howell, NJ 07731
Starting therapy can be an overwhelming task, but I hope I can help make this step seem a little more manageable. I work with adolescents and adults ages 13+. I specialize in anxiety, depression, perinatal and postpartum mental health, trauma, and addictions. I don't believe therapy is "one size fits all", and I strive to work with the client to find the best interventions to help meet their goals. I utilize a strengths-based approach along with cognitive behavioral interventions and motivational strategies.
Starting therapy can be an overwhelming task, but I hope I can help make this step seem a little more manageable. I work with adolescents and adults ages 13+. I specialize in anxiety, depression, perinatal and postpartum mental health, trauma, and addictions. I don't believe therapy is "one size fits all", and I strive to work with the client to find the best interventions to help meet their goals. I utilize a strengths-based approach along with cognitive behavioral interventions and motivational strategies.
(732) 655-3542 View (732) 655-3542

See more therapy options for Howell

How does your Therapist compare?

Number of Therapists in Howell, NJ

100+

Average cost per session

$150

Therapists in Howell, NJ who prioritize treating:

90% Anxiety
90% Social Anxiety
90% Health Anxiety
90% Driving Anxiety
85% Depression
79% Self Esteem
75% Relationship Issues

Average years in practice

12 Years

Top 3 insurances accepted

91% Aetna
81% Horizon Blue Cross and Blue Shield
61% BlueCross and BlueShield

How Therapists in Howell, NJ see their clients

62% In Person and Online
38% Online Only

Gender breakdown

86% Female
13% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Howell?

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.