Therapists in Kenmore, NY

Photo of Tessa Bechtold-Brown, Counselor in Kenmore, NY
Tessa Bechtold-Brown
Counselor, LMHC, MS
Verified Verified
1 Endorsed
Kenmore, NY 14217
Life is stressful and distracting enough without putting others needs above your own. But that’s what we tend to do! As a result we are left feeling drained. Relationships are complicated – whether it be with yourself or others. Throughout our lifetime relationships are often the most neglected and yet one of the most important. It is through the relationship with yourself and others that personal growth and change develops. This requires looking inward to discover what you need, want, and desire.
Life is stressful and distracting enough without putting others needs above your own. But that’s what we tend to do! As a result we are left feeling drained. Relationships are complicated – whether it be with yourself or others. Throughout our lifetime relationships are often the most neglected and yet one of the most important. It is through the relationship with yourself and others that personal growth and change develops. This requires looking inward to discover what you need, want, and desire.
(716) 229-5912 View (716) 229-5912
Photo of Amie Martinez, Mental Health Counselor in Kenmore, NY
Amie Martinez
Mental Health Counselor, LMHC
Verified Verified
Kenmore, NY 14217
In life’s journey, we are all met with obstacles to overcome. Sometimes they are small ant hills that we can step over, sometimes they are small hills that we struggle to get over, and sometimes they can feel like insurmountable mountains. For each of us, our hills and mountains (and how they feel) might be different. Sometimes those ant hills can feel like a mountain as well. It may feel like you do not have the tools to get over those obstacles safely and securely. If you are ready to get those tools, then this may be the next step on your journey to healing.
In life’s journey, we are all met with obstacles to overcome. Sometimes they are small ant hills that we can step over, sometimes they are small hills that we struggle to get over, and sometimes they can feel like insurmountable mountains. For each of us, our hills and mountains (and how they feel) might be different. Sometimes those ant hills can feel like a mountain as well. It may feel like you do not have the tools to get over those obstacles safely and securely. If you are ready to get those tools, then this may be the next step on your journey to healing.
(716) 592-6670 View (716) 592-6670
Photo of Kathryn Raffloer, Counselor in Kenmore, NY
Kathryn Raffloer
Counselor, LMHC
Verified Verified
Kenmore, NY 14217
Have you noticed that life is beginning to feel too much lately? Feeling overwhelmed and easily distracted? Are there things in the past that you feel you cannot let go of? All of these things can be frustrating and impact all areas of your life. You want to feel more productive or more at peace with life with managing what life can through at you. You just are not sure where to start or if you can do it on your own. I’m here to tell you that you can make the changes in your life and I can help guide and support this process.
Have you noticed that life is beginning to feel too much lately? Feeling overwhelmed and easily distracted? Are there things in the past that you feel you cannot let go of? All of these things can be frustrating and impact all areas of your life. You want to feel more productive or more at peace with life with managing what life can through at you. You just are not sure where to start or if you can do it on your own. I’m here to tell you that you can make the changes in your life and I can help guide and support this process.
(716) 455-2174 View (716) 455-2174
Photo of Emily Mallone, Clinical Social Work/Therapist in Kenmore, NY
Emily Mallone
Clinical Social Work/Therapist, LCSW
Verified Verified
Kenmore, NY 14217  (Online Only)
Emily specializes in working with adults who struggle with anxiety, stress, navigating life changes, and depression. She strives to provide a safe and comfortable environment for clients to freely discuss their thoughts and feelings without any judgement. Sometimes it can be hard to untangle the anxious thoughts that can arise for many reasons throughout our life, Emily aims to help you process and cope with these. Her psychotherapy approach provides so many benefits including emotional support, increased insight into yourself and challenges you may be experiencing, building coping skills, and fostering personal growth.
Emily specializes in working with adults who struggle with anxiety, stress, navigating life changes, and depression. She strives to provide a safe and comfortable environment for clients to freely discuss their thoughts and feelings without any judgement. Sometimes it can be hard to untangle the anxious thoughts that can arise for many reasons throughout our life, Emily aims to help you process and cope with these. Her psychotherapy approach provides so many benefits including emotional support, increased insight into yourself and challenges you may be experiencing, building coping skills, and fostering personal growth.
(716) 215-7036 View (716) 215-7036
Photo of Alicia Kaufman-Bernhardt, Clinical Social Work/Therapist in Kenmore, NY
Alicia Kaufman-Bernhardt
Clinical Social Work/Therapist, LCSW, CASAC-M
Verified Verified
1 Endorsed
Kenmore, NY 14217
Taking the first steps towards working on yourself can be intimidating, but here you are, doing it. Take a moment to be proud of this step and know that you can take the next one too. If you find yourself in a situation where you're encountering obstacles and in the process of grappling with the weight of anxiety or depression or feeling overwhelmed by the challenges of adapting to significant life changes, I want to assure you that I may be the right person to guide you on your journey toward achieving your goals. I'm here to provide you with a compassionate and understanding approach.
Taking the first steps towards working on yourself can be intimidating, but here you are, doing it. Take a moment to be proud of this step and know that you can take the next one too. If you find yourself in a situation where you're encountering obstacles and in the process of grappling with the weight of anxiety or depression or feeling overwhelmed by the challenges of adapting to significant life changes, I want to assure you that I may be the right person to guide you on your journey toward achieving your goals. I'm here to provide you with a compassionate and understanding approach.
(716) 588-4398 View (716) 588-4398
Photo of Jessica Ackley in Kenmore, NY
Jessica Ackley
MHC-P
Verified Verified
1 Endorsed
Kenmore, NY 14217  (Online Only)
I am a mental health counselor with a limited permit to practice in New York. I have additional training in EMDR, dissociation, and historical trauma, and years of experience working in crisis management, the hospital setting, and in community-based mental health and wellness centers. My practice focuses on working with children, teens, adults, couples and families, using an eclectic therapeutic approach. I received my M.S. in Clinical Mental Health Counseling and B.A. in Psychology/Sociology from St. Bonaventure University.
I am a mental health counselor with a limited permit to practice in New York. I have additional training in EMDR, dissociation, and historical trauma, and years of experience working in crisis management, the hospital setting, and in community-based mental health and wellness centers. My practice focuses on working with children, teens, adults, couples and families, using an eclectic therapeutic approach. I received my M.S. in Clinical Mental Health Counseling and B.A. in Psychology/Sociology from St. Bonaventure University.
(716) 217-0010 View (716) 217-0010
Photo of Alicia Marie Chase, Clinical Social Work/Therapist in Kenmore, NY
Alicia Marie Chase
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Kenmore, NY 14217  (Online Only)
Life doesn’t always lead us down the pathways we expected. Sometimes we find ourselves feeling lost, alone, and unsure of which way to turn. Anxiety, depression, PTSD, OCD and other symptoms can feel smothering and overwhelming leaving us with a feeling of hopelessness and sense of loss of control. The things we experience as we grow and develop impact the way we view the world. Traumatic events and negative experiences can change the way we think and respond.
Life doesn’t always lead us down the pathways we expected. Sometimes we find ourselves feeling lost, alone, and unsure of which way to turn. Anxiety, depression, PTSD, OCD and other symptoms can feel smothering and overwhelming leaving us with a feeling of hopelessness and sense of loss of control. The things we experience as we grow and develop impact the way we view the world. Traumatic events and negative experiences can change the way we think and respond.
(716) 588-4548 View (716) 588-4548
Photo of Dominique Walkowiak, Counselor in Kenmore, NY
Dominique Walkowiak
Counselor, LMHC
Verified Verified
1 Endorsed
Kenmore, NY 14217
There are times when life seems overwhelming. Everything is confusing and frustrating and it feels like you’ll never be at peace: anxiety, depression, anger and self-doubt give way to issues in relationships, inability to fulfill responsibilities at work or home, and turning to unhealthy coping behaviors. Since you’re reading this, you want out of this endless cycle and to live differently. Maybe you want to be able to build healthier relationships with those around you. Do you want to be a better partner, parent or friend?
There are times when life seems overwhelming. Everything is confusing and frustrating and it feels like you’ll never be at peace: anxiety, depression, anger and self-doubt give way to issues in relationships, inability to fulfill responsibilities at work or home, and turning to unhealthy coping behaviors. Since you’re reading this, you want out of this endless cycle and to live differently. Maybe you want to be able to build healthier relationships with those around you. Do you want to be a better partner, parent or friend?
(716) 229-4352 View (716) 229-4352
Photo of Alex Meli, PMHNP, Counselor in Kenmore, NY
Alex Meli, PMHNP
Counselor, PMHNP
Verified Verified
Kenmore, NY 14217
As a board-certified Psychiatric Nurse Practitioner, I specialize in providing care for individuals with a wide range of mental health concerns. Mental health disorders that I specialize in include, depression, anxiety, trauma/PTSD, bipolar disorder, psychosis/schizophrenia, OCD, ADHD, and substance use disorders.
As a board-certified Psychiatric Nurse Practitioner, I specialize in providing care for individuals with a wide range of mental health concerns. Mental health disorders that I specialize in include, depression, anxiety, trauma/PTSD, bipolar disorder, psychosis/schizophrenia, OCD, ADHD, and substance use disorders.
(716) 466-9154 x2 View (716) 466-9154 x2
Adam Scheldt
Pastoral Counselor, MAHL, MARE, CSD
Verified Verified
Kenmore, NY 14217  (Online Only)
I help my clients cultivate meaning, healing, and wholeness in their lives. Through spiritually grounded counseling, I work with clients to help them become closer to their ideal selves. Our work together can serve as an excellent compliment to other clinical modes of counseling, or as a stand-alone service to help you find solace, healing, and growth.
I help my clients cultivate meaning, healing, and wholeness in their lives. Through spiritually grounded counseling, I work with clients to help them become closer to their ideal selves. Our work together can serve as an excellent compliment to other clinical modes of counseling, or as a stand-alone service to help you find solace, healing, and growth.
(716) 222-8667 View (716) 222-8667
Photo of Be Embodied, LLC, Counselor in Kenmore, NY
Be Embodied, LLC
Counselor, LMHC, PhD, PMHNP
Verified Verified
Kenmore, NY 14217
From the moment you walk through our doors, you are welcomed into an atmosphere of soothing mindfulness and healing. You are invited to relax as you are greeted by our warm and welcoming staff. You are offered a space to be supported and empowered by the community of providers and teachers that await you. Since 2018, Be Embodied, LLC, has chosen to build a new paradigm. We are a holistic group practice that brings mental, physical and spiritual providers together under one roof to provide our community with the holistic, trauma informed, collaborative care they deserve.
From the moment you walk through our doors, you are welcomed into an atmosphere of soothing mindfulness and healing. You are invited to relax as you are greeted by our warm and welcoming staff. You are offered a space to be supported and empowered by the community of providers and teachers that await you. Since 2018, Be Embodied, LLC, has chosen to build a new paradigm. We are a holistic group practice that brings mental, physical and spiritual providers together under one roof to provide our community with the holistic, trauma informed, collaborative care they deserve.
(716) 557-4397 View (716) 557-4397
Photo of Olivia Geary in Kenmore, NY
Olivia Geary
MHC-P
Verified Verified
1 Endorsed
Kenmore, NY 14217  (Online Only)
Currently accepting new clients! I am a mental health counselor with a limited permit to practice in New York. I have additional training in grief and trauma-informed care and experience in several settings including a psychiatric and rehabilitation hospital, a Buffalo charter school, and agencies. My focus is with adults, families, and couples utilizing an eclectic therapeutic approach in order to successfully meet the needs of a plethora of different and unique presenting issues. I obtained my M.S. from Canisius College and B.A in psychology from Buffalo State University. I am also a member of the American Counseling Association.
Currently accepting new clients! I am a mental health counselor with a limited permit to practice in New York. I have additional training in grief and trauma-informed care and experience in several settings including a psychiatric and rehabilitation hospital, a Buffalo charter school, and agencies. My focus is with adults, families, and couples utilizing an eclectic therapeutic approach in order to successfully meet the needs of a plethora of different and unique presenting issues. I obtained my M.S. from Canisius College and B.A in psychology from Buffalo State University. I am also a member of the American Counseling Association.
(716) 217-0010 View (716) 217-0010
Photo of Megan Friol, Counselor in Kenmore, NY
Megan Friol
Counselor, LMHC
Verified Verified
Kenmore, NY 14217  (Online Only)
I am a licensed mental health counselor in New York specializing in trauma, anxiety, depression, and general mental health. I am passionate about working with adults and children on an individual basis, using an eclectic therapeutic approach. I hope that my collaborative, empathetic, and trauma-informed perspective will support people in achieving their goals.
I am a licensed mental health counselor in New York specializing in trauma, anxiety, depression, and general mental health. I am passionate about working with adults and children on an individual basis, using an eclectic therapeutic approach. I hope that my collaborative, empathetic, and trauma-informed perspective will support people in achieving their goals.
(716) 217-0010 View (716) 217-0010
Photo of David V. Pew, Licensed Professional Counselor in Kenmore, NY
David V. Pew
Licensed Professional Counselor, LMHC
Verified Verified
Kenmore, NY 14217
Waitlist for new clients
Have you often felt lately that life has seemed increasingly overwhelming? Perhaps that each day you are just trying to get through, hoping the next day will be better... but left feeling more and more discouraged as each day passes? Do you struggle identifying your emotions or communicating how you feel in your interpersonal relationships? In my experience, many individuals often know something needs to change, but are understandably unsure of how or where to begin seeking help. If you are interested in understanding yourself better and how past experiences may be influencing current dynamics in your life, please reach out to me!
Have you often felt lately that life has seemed increasingly overwhelming? Perhaps that each day you are just trying to get through, hoping the next day will be better... but left feeling more and more discouraged as each day passes? Do you struggle identifying your emotions or communicating how you feel in your interpersonal relationships? In my experience, many individuals often know something needs to change, but are understandably unsure of how or where to begin seeking help. If you are interested in understanding yourself better and how past experiences may be influencing current dynamics in your life, please reach out to me!
(716) 919-6333 View (716) 919-6333
Photo of Lisa Marek, Counselor in Kenmore, NY
Lisa Marek
Counselor, LMHC
Verified Verified
1 Endorsed
Kenmore, NY 14217  (Online Only)
Currently accepting new clients! I am a licensed mental health counselor in New York. I am certified in Dialectical Behavioral Therapy (DBT) and have additional training in Grief and Loss, and Cognitive Behavioral Therapy to treat anxiety and depression. I believe good mental health is equally as important as good physical health. I am enthusiastic about helping people to achieve and maintain balance in their lives. Primary to my approach is a good therapeutic alliance between myself and the people I provide therapy to. I try to meet you where you are at, by listening and seeking to understand your needs and desires.
Currently accepting new clients! I am a licensed mental health counselor in New York. I am certified in Dialectical Behavioral Therapy (DBT) and have additional training in Grief and Loss, and Cognitive Behavioral Therapy to treat anxiety and depression. I believe good mental health is equally as important as good physical health. I am enthusiastic about helping people to achieve and maintain balance in their lives. Primary to my approach is a good therapeutic alliance between myself and the people I provide therapy to. I try to meet you where you are at, by listening and seeking to understand your needs and desires.
(716) 217-0010 View (716) 217-0010
Photo of Khadijah Winkelman, Counselor in Kenmore, NY
Khadijah Winkelman
Counselor, LMHC
Verified Verified
1 Endorsed
Kenmore, NY 14217
Waitlist for new clients
With several years experience working with families, parents, and adolescents in both community and clinic settings, I have had the opportunity of working with people in all walks of life. Thus far in my career, I have found working with underserved and marginalized populations to be most rewarding. A key part of my counseling style is helping clients shift their focus from what they cannot control and centering in on what they can. Clients will take away from our sessions the ability to identify healthy ways to work through conflicts within themselves as well as with their children, parents, peers, etc.
With several years experience working with families, parents, and adolescents in both community and clinic settings, I have had the opportunity of working with people in all walks of life. Thus far in my career, I have found working with underserved and marginalized populations to be most rewarding. A key part of my counseling style is helping clients shift their focus from what they cannot control and centering in on what they can. Clients will take away from our sessions the ability to identify healthy ways to work through conflicts within themselves as well as with their children, parents, peers, etc.
(716) 466-9165 View (716) 466-9165
Photo of Brianne Rehac, Counselor in Kenmore, NY
Brianne Rehac
Counselor, LMHC
Verified Verified
2 Endorsed
Kenmore, NY 14217
In a world full of AI, sometimes you need to talk to a real person. We are so busy with work, scrolling, and trying to keep up with the news cycle. It can be exhausting. I help people who are used to being able to juggle all of it learn what they can set down and how to do it without feeling guilty. Some of my clients are moms, others are bosses (some are boss moms!). I work with athletes, artists, and entrepreneurs. The common thread between them all seems to be stress, anxiety, and exhaustion.
In a world full of AI, sometimes you need to talk to a real person. We are so busy with work, scrolling, and trying to keep up with the news cycle. It can be exhausting. I help people who are used to being able to juggle all of it learn what they can set down and how to do it without feeling guilty. Some of my clients are moms, others are bosses (some are boss moms!). I work with athletes, artists, and entrepreneurs. The common thread between them all seems to be stress, anxiety, and exhaustion.
(716) 265-4652 View (716) 265-4652
Photo of Anthony Lobuzzetta, Counselor in Kenmore, NY
Anthony Lobuzzetta
Counselor, LMHC
Verified Verified
Kenmore, NY 14217
Everyone deserves someone in their life whom they can trust. You deserve to be heard, and to have someone in your life that is actually listening. My goal is to be that person for my clients. Through a therapeutic relationship grounded in empathy and genuineness, we can work together to give you the power to tackle the issues most concerning you. By using cognitive-behavioral skills and mindfulness techniques, my goal is to expose my clients to the value of self-worth, the importance of nurturing one’s self-worth, and ultimately crafting a more optimistic version of one's self and their future.
Everyone deserves someone in their life whom they can trust. You deserve to be heard, and to have someone in your life that is actually listening. My goal is to be that person for my clients. Through a therapeutic relationship grounded in empathy and genuineness, we can work together to give you the power to tackle the issues most concerning you. By using cognitive-behavioral skills and mindfulness techniques, my goal is to expose my clients to the value of self-worth, the importance of nurturing one’s self-worth, and ultimately crafting a more optimistic version of one's self and their future.
(716) 412-2064 View (716) 412-2064
Photo of Steven William Halady, Clinical Social Work/Therapist in Kenmore, NY
Steven William Halady
Clinical Social Work/Therapist, PhD, LCSW
Verified Verified
Kenmore, NY 14217
Not accepting new clients
There is probably something in your life that you wish would change. Perhaps you are on the fence with a big decision, or a major change has occurred. Whatever brought you here, by reading this you have already taken the first step toward making that change. You are exploring your options and trying to decide if reaching out to a professional will help you to take your next steps. Whatever those next steps may be, working with a nonjudgmental and empathetic professional can be one of the most effective and rewarding ways to get you to where you want to be.
There is probably something in your life that you wish would change. Perhaps you are on the fence with a big decision, or a major change has occurred. Whatever brought you here, by reading this you have already taken the first step toward making that change. You are exploring your options and trying to decide if reaching out to a professional will help you to take your next steps. Whatever those next steps may be, working with a nonjudgmental and empathetic professional can be one of the most effective and rewarding ways to get you to where you want to be.
(716) 281-1632 View (716) 281-1632
Photo of Kristie Newman, Counselor in Kenmore, NY
Kristie Newman
Counselor, LMHC
Verified Verified
1 Endorsed
Kenmore, NY 14217  (Online Only)
Having support during life’s most challenging moments isn’t always easy to come by. Allow me to provide you with a safe space to be vulnerable and cared for. I aim to provide a therapeutic yet collaborative environment for my clients to succeed. The choice to start, or restart therapy can be overwhelming, but I implore you to be courageous for you. I work with individuals experiencing anxiety, depression, PTSD, phase of life challenges and interpersonal conflicts. I serve as a guide as we navigate the rough but manageable road ahead.
Having support during life’s most challenging moments isn’t always easy to come by. Allow me to provide you with a safe space to be vulnerable and cared for. I aim to provide a therapeutic yet collaborative environment for my clients to succeed. The choice to start, or restart therapy can be overwhelming, but I implore you to be courageous for you. I work with individuals experiencing anxiety, depression, PTSD, phase of life challenges and interpersonal conflicts. I serve as a guide as we navigate the rough but manageable road ahead.
(716) 393-5082 View (716) 393-5082

See more therapy options for Kenmore

How does your Therapist compare?

Number of Therapists in Kenmore, NY

40+

Average cost per session

$150

Therapists in Kenmore, NY who prioritize treating:

98% Anxiety
94% Depression
86% Self Esteem
86% Stress
82% Trauma and PTSD
82% Coping Skills
80% Relationship Issues

Average years in practice

11 Years

Top 3 insurances accepted

58% Aetna
56% BlueCross and BlueShield
56% Highmark BCBS of Western New York

How Therapists in Kenmore, NY see their clients

68% In Person and Online
32% Online Only

Gender breakdown

91% Female
9% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Kenmore?

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.