Therapists in Monticello, NY

Photo of Nicole Picarello, Clinical Social Work/Therapist, LCSW
Nicole Picarello
Clinical Social Work/Therapist, LCSW
Online Only
Are you looking for support in working through past or present struggles that continue to affect your mental health? You deserve a space where you can feel heard, understood, and supported. Through an integrative counseling approach, you receive care that is tailored to your unique needs, helping you make sense of your experiences and move toward greater emotional well-being. Modalities include talk therapy, CBT, meditation, stress management, and more.
Are you looking for support in working through past or present struggles that continue to affect your mental health? You deserve a space where you can feel heard, understood, and supported. Through an integrative counseling approach, you receive care that is tailored to your unique needs, helping you make sense of your experiences and move toward greater emotional well-being. Modalities include talk therapy, CBT, meditation, stress management, and more.
(845) 606-4075 View (845) 606-4075
Photo of LaToya J Johnson, Counselor, LMHC
LaToya J Johnson
Counselor, LMHC
Online Only
Hello, I am LaToya J. Johnson, an NYS Licensed Mental Health Counselor with over 20 years of counseling experience. I have provided care to individuals with chronic mental illnesses, including bipolar disorder, major depressive disorder, schizophrenia, anxiety, PTSD, racial identity issues, relationship concerns, intellectual disabilities, and substance abuse. The most common theoretical approaches I use in my work are Cognitive Behavioral Therapy, Psychodynamic Therapy, Trauma Informed Care, and Person Center Therapy. I believe every person has a right to live a happy and fulfilled life.
Hello, I am LaToya J. Johnson, an NYS Licensed Mental Health Counselor with over 20 years of counseling experience. I have provided care to individuals with chronic mental illnesses, including bipolar disorder, major depressive disorder, schizophrenia, anxiety, PTSD, racial identity issues, relationship concerns, intellectual disabilities, and substance abuse. The most common theoretical approaches I use in my work are Cognitive Behavioral Therapy, Psychodynamic Therapy, Trauma Informed Care, and Person Center Therapy. I believe every person has a right to live a happy and fulfilled life.
(646) 798-7620 View (646) 798-7620
Photo of Laurel Bertram, Clinical Social Work/Therapist, LCSW, CASAC
Laurel Bertram
Clinical Social Work/Therapist, LCSW, CASAC
Monticello, NY 12701
Not accepting new clients
My scope of practice includes treating individuals diagnosed with Depression, Anxiety, BiPolar Disorder, Mood Disorders, Personality Disorders, PTSD, ADHD, Eating Disorders/Obesity, and Substance Use Disorders. I believe in a multifaceted approach to treatment with individualized attention to client's specific needs. Having been employed by a major Regional Hospital as a psychiatric/addiction professional managing Emergency Room assessments and detox services on the medical/mental health units for the last five years, I have gained new insights to effective treatment planning, and improving functionality. My experience includes in-patient as well as out-patient behavioral health treatment working with adults, couples, families, and adolescents.
My scope of practice includes treating individuals diagnosed with Depression, Anxiety, BiPolar Disorder, Mood Disorders, Personality Disorders, PTSD, ADHD, Eating Disorders/Obesity, and Substance Use Disorders. I believe in a multifaceted approach to treatment with individualized attention to client's specific needs. Having been employed by a major Regional Hospital as a psychiatric/addiction professional managing Emergency Room assessments and detox services on the medical/mental health units for the last five years, I have gained new insights to effective treatment planning, and improving functionality. My experience includes in-patient as well as out-patient behavioral health treatment working with adults, couples, families, and adolescents.
(845) 208-8122 View (845) 208-8122
Photo of James Ellis, Licensed Mental Health Counselor, LPC
James Ellis
Licensed Mental Health Counselor, LPC
Online Only
I am skilled in helping those who may have struggled to find a therapeutic home. I have helped many learn skills which allow them to navigate their daily lives. Having interned at The Center in New York City, I am an advocate for those who identify as LGBTQ, with a particular interest in grief and bereavement. I enjoy working with people of all walks of life, while meeting people where they are, and will see clients aged 7 and up. Additionally, I have worked with trauma survivors - including those struggling with domestic violence, ADHD, autism, geriatric clients, transitioning, couples, and medical issues - both acute and chronic.
I am skilled in helping those who may have struggled to find a therapeutic home. I have helped many learn skills which allow them to navigate their daily lives. Having interned at The Center in New York City, I am an advocate for those who identify as LGBTQ, with a particular interest in grief and bereavement. I enjoy working with people of all walks of life, while meeting people where they are, and will see clients aged 7 and up. Additionally, I have worked with trauma survivors - including those struggling with domestic violence, ADHD, autism, geriatric clients, transitioning, couples, and medical issues - both acute and chronic.
(845) 482-0393 View (845) 482-0393
Photo of Heather M Trotta, Art Therapist, LCAT
Heather M Trotta
Art Therapist, LCAT
1 Endorsed
Online Only
If you’re feeling overwhelmed by anxiety, stuck in cycles of depression, or navigating intense emotions that seem to shift quickly, you’re not alone—and you don’t have to manage it on your own. You might find yourself overthinking, feeling deeply affected by others, struggling with self-worth, or caught in patterns in relationships that feel confusing or painful. At times, it may feel hard to regulate your emotions or even understand where they’re coming from. Art therapy can be a space where those experiences begin to make sense.
If you’re feeling overwhelmed by anxiety, stuck in cycles of depression, or navigating intense emotions that seem to shift quickly, you’re not alone—and you don’t have to manage it on your own. You might find yourself overthinking, feeling deeply affected by others, struggling with self-worth, or caught in patterns in relationships that feel confusing or painful. At times, it may feel hard to regulate your emotions or even understand where they’re coming from. Art therapy can be a space where those experiences begin to make sense.
(845) 273-3774 View (845) 273-3774
Photo of Stephen Mcfadden, Clinical Social Work/Therapist, LCSW
Stephen Mcfadden
Clinical Social Work/Therapist, LCSW
Online Only
My commitment is to help you feel better and learn ways to change problematic patterns within the first few sessions. I combine different methods (talk therapy, hypnosis, EMDR and Somatic Experiencing) to help people make positive changes in their lives. I have 30+ years experience, with specialization in relationship problems, sexuality issues, and recovery from childhood and adult trauma. My approach is highly interactive. Sessions involve feedback and teaching of methods and skills to help you get your life back on track.
My commitment is to help you feel better and learn ways to change problematic patterns within the first few sessions. I combine different methods (talk therapy, hypnosis, EMDR and Somatic Experiencing) to help people make positive changes in their lives. I have 30+ years experience, with specialization in relationship problems, sexuality issues, and recovery from childhood and adult trauma. My approach is highly interactive. Sessions involve feedback and teaching of methods and skills to help you get your life back on track.
(646) 699-3926 View (646) 699-3926
Photo of Dr. Juliet Skeete, Clinical Social Work/Therapist, DHA, LCSW
Dr. Juliet Skeete
Clinical Social Work/Therapist, DHA, LCSW
2 Endorsed
Online Only
If you are struggling with unresolved trauma, grief or loss, if you are trying to cope with depression or anxiety, if you and your partner have forgotten your love language, reach out. As a compassionate listener I provide a judgment free, supportive environment. I am now offering teletherapy so that you can receive support in the comfort of your chosen venue at flexible times. I am a Licensed Clinical Social worker with extensive clinical experience in hospitals, clinics and private practice settings.
If you are struggling with unresolved trauma, grief or loss, if you are trying to cope with depression or anxiety, if you and your partner have forgotten your love language, reach out. As a compassionate listener I provide a judgment free, supportive environment. I am now offering teletherapy so that you can receive support in the comfort of your chosen venue at flexible times. I am a Licensed Clinical Social worker with extensive clinical experience in hospitals, clinics and private practice settings.
(929) 383-7463 View (929) 383-7463
Photo of Rebecca Norman, Clinical Social Work/Therapist, LCSW
Rebecca Norman
Clinical Social Work/Therapist, LCSW
Online Only
As a dedicated and compassionate therapist, I strive to create a safe and supportive environment for my clients. With 13 years of experience specializing in a range of treatments from attachment focused therapy, CBT, mindfulness, and relational work, I am committed to helping individuals navigate their unique challenges. My approach is warm, collaborative, and client centered, focusing on understanding your perspective and what may be getting in the way of achieving your goals. I believe in the power of resilience and am here to help guide you on your journey toward personal growth and emotional well-being, unlocking your best self
As a dedicated and compassionate therapist, I strive to create a safe and supportive environment for my clients. With 13 years of experience specializing in a range of treatments from attachment focused therapy, CBT, mindfulness, and relational work, I am committed to helping individuals navigate their unique challenges. My approach is warm, collaborative, and client centered, focusing on understanding your perspective and what may be getting in the way of achieving your goals. I believe in the power of resilience and am here to help guide you on your journey toward personal growth and emotional well-being, unlocking your best self
(631) 309-2448 View (631) 309-2448
Photo of Alex Roth, Art Therapist, ATR-BC, LCAT
Alex Roth
Art Therapist, ATR-BC, LCAT
Serves Area
Are you noticing patterns in your life that feel difficult to break? If anxiety, trauma, or fear has been interfering with your ability to feel grounded, I strive to provide a safe and supportive environment where clients feel understood and empowered as they work toward growth and healing.Together we explore the patterns that may be contributing to distress while developing clear, measurable strategies that help you feel more confident, regulated, and capable in daily life. For your convenience immediate therapy appointments are now available.
Are you noticing patterns in your life that feel difficult to break? If anxiety, trauma, or fear has been interfering with your ability to feel grounded, I strive to provide a safe and supportive environment where clients feel understood and empowered as they work toward growth and healing.Together we explore the patterns that may be contributing to distress while developing clear, measurable strategies that help you feel more confident, regulated, and capable in daily life. For your convenience immediate therapy appointments are now available.
(929) 470-3505 View (929) 470-3505
Photo of Alyssa Gau, Counselor, LMHC
Alyssa Gau
Counselor, LMHC
1 Endorsed
Serves Area
Take a breath. Making the choice to begin therapy is rarely an easy one. It can feel stressful and overwhelming - much like life itself. I welcome the opportunity to help guide you on this journey. My approach is collaborative and based around the belief that meaningful change occurs when people feel safe and supported. I am passionate about working with individuals struggling with disordered eating, depression and anxiety.
Take a breath. Making the choice to begin therapy is rarely an easy one. It can feel stressful and overwhelming - much like life itself. I welcome the opportunity to help guide you on this journey. My approach is collaborative and based around the belief that meaningful change occurs when people feel safe and supported. I am passionate about working with individuals struggling with disordered eating, depression and anxiety.
(845) 720-3849 View (845) 720-3849
Photo of Alanna E Newman - The Porch Therapy Studio, Clinical Social Work/Therapist, LCSW, Ms Ed
The Porch Therapy Studio
Clinical Social Work/Therapist, LCSW, Ms Ed
2 Endorsed
Serves Area
You don’t have to keep holding everything together on your own. If you’re feeling overwhelmed, anxious, burned out, or just not like yourself lately—you’re not alone. I work with teachers, moms, and kids who are carrying a lot and need a space to finally exhale. As a therapist, my style is warm, real, and down-to-earth. I create a space where you can talk openly without feeling judged or “clinical.” Whether you're navigating stress from the classroom, the demands of parenting, or just trying to get through the day. "I provide virtual therapy sessions to clients in NY,GA, AL,CA. Those locations are not physical office locations. "
You don’t have to keep holding everything together on your own. If you’re feeling overwhelmed, anxious, burned out, or just not like yourself lately—you’re not alone. I work with teachers, moms, and kids who are carrying a lot and need a space to finally exhale. As a therapist, my style is warm, real, and down-to-earth. I create a space where you can talk openly without feeling judged or “clinical.” Whether you're navigating stress from the classroom, the demands of parenting, or just trying to get through the day. "I provide virtual therapy sessions to clients in NY,GA, AL,CA. Those locations are not physical office locations. "
(478) 707-2721 View (478) 707-2721
Photo of Rebekah Feliciano, Clinical Social Work/Therapist, LCSW
Rebekah Feliciano
Clinical Social Work/Therapist, LCSW
Online Only
We cannot control the challenges that we face, but we can control how we process our pain and tap into our own resilience. Seeking psychotherapy can be the first step towards achieving purpose and a better quality of life. I work with individuals, teens, families and couples to identify areas of improvement, foster change, cope with symptoms, and achieve goals. A history of trauma (emotional, physical, sexual, abandonment, domestic violence) or medical difficulties such as chronic/terminal illness or pain can complicate treatment needs and clients can respond differently to psychotherapy when these elements are present.
We cannot control the challenges that we face, but we can control how we process our pain and tap into our own resilience. Seeking psychotherapy can be the first step towards achieving purpose and a better quality of life. I work with individuals, teens, families and couples to identify areas of improvement, foster change, cope with symptoms, and achieve goals. A history of trauma (emotional, physical, sexual, abandonment, domestic violence) or medical difficulties such as chronic/terminal illness or pain can complicate treatment needs and clients can respond differently to psychotherapy when these elements are present.
(914) 415-6901 View (914) 415-6901
Photo of Kedin Kilgore, Clinical Social Work/Therapist, LMSW, IFS, C-ISTT, EFT
Kedin Kilgore
Clinical Social Work/Therapist, LMSW, IFS, C-ISTT, EFT
2 Endorsed
Serves Area
I’m Kedin Kilgore, LMSW — a therapist working with couples and individuals. With couples, I work within an EFT framework — tracking the cycles of pursuit and withdrawal that erode connection, and helping partners reach beneath conflict to the unmet attachment needs driving them. For clients with mood conditions IFS and Somatic Trauma Therapy can support you to better understand your inner world, not just manage it. For clients with living with Bi-Polar cycles I work alongside your psychiatric and medical care. My approach is direct, collaborative, and grounded in the belief that insight and acceptance can coexist.
I’m Kedin Kilgore, LMSW — a therapist working with couples and individuals. With couples, I work within an EFT framework — tracking the cycles of pursuit and withdrawal that erode connection, and helping partners reach beneath conflict to the unmet attachment needs driving them. For clients with mood conditions IFS and Somatic Trauma Therapy can support you to better understand your inner world, not just manage it. For clients with living with Bi-Polar cycles I work alongside your psychiatric and medical care. My approach is direct, collaborative, and grounded in the belief that insight and acceptance can coexist.
(929) 207-8410 View (929) 207-8410
Photo of Deborah Chandler, Psychologist, PhD
Deborah Chandler
Psychologist, PhD
Serves Area
I am most effective when working with a patient who wants to change but feels frustrated with how to make this happen.
I am most effective when working with a patient who wants to change but feels frustrated with how to make this happen.
(845) 377-0570 View (845) 377-0570
Photo of Thomasina Brown, MA, MS, CAMS
Thomasina Brown
Verified Verified
1 Endorsed
Online Only
I am a Certified Anger Management Specialist that builds healthy relationships with my clients. I take pride in learning about my clients so I can be effective by creating an intervention plan specifically for each client based on their needs. I empower my clients by utilizing coaching and different positive techniques from Cognitive Behavior Therapy. I provide services through 4 or more sessions and I am available via phone or text after hours for support if needed in between sessions.
I am a Certified Anger Management Specialist that builds healthy relationships with my clients. I take pride in learning about my clients so I can be effective by creating an intervention plan specifically for each client based on their needs. I empower my clients by utilizing coaching and different positive techniques from Cognitive Behavior Therapy. I provide services through 4 or more sessions and I am available via phone or text after hours for support if needed in between sessions.
(845) 832-4102 View (845) 832-4102
Photo of Brandon Knopp, Counselor, LMHC, NCC, MA
Brandon Knopp
Counselor, LMHC, NCC, MA
3 Endorsed
Online Only
Not accepting new clients
I help my clients navigate their experiences with life transitions, relationship challenges, losses, personal development, new stressors, and the mental, emotional and spiritual growth that often appears alongside these challenges. In therapy, we use these presenting circumstances as a jumping off point, form a strong and consistent therapeutic container, and together, dive into a deeper exploration.
I help my clients navigate their experiences with life transitions, relationship challenges, losses, personal development, new stressors, and the mental, emotional and spiritual growth that often appears alongside these challenges. In therapy, we use these presenting circumstances as a jumping off point, form a strong and consistent therapeutic container, and together, dive into a deeper exploration.
View
Photo of Joseph R. Scrivani, Clinical Social Work/Therapist, MSW, LCSW
Joseph R. Scrivani
Clinical Social Work/Therapist, MSW, LCSW
7 Endorsed
Serves Area
Making the decision to change or start something new is never easy, therapy included. Let me help you make the change you want in your life! I have been helping people do just that for over 20 years. My clients are adults of all genders & sexual orientations. It's been my experience that therapy works best when you and your therapist share a sense of trust & comfort. This helps increase motivation. Primary issues treated are depression, anxiety, lack of satisfaction in relationships & careers, self-esteem, grief and living with chronic illness.
Making the decision to change or start something new is never easy, therapy included. Let me help you make the change you want in your life! I have been helping people do just that for over 20 years. My clients are adults of all genders & sexual orientations. It's been my experience that therapy works best when you and your therapist share a sense of trust & comfort. This helps increase motivation. Primary issues treated are depression, anxiety, lack of satisfaction in relationships & careers, self-esteem, grief and living with chronic illness.
(917) 746-0276 View (917) 746-0276

More Therapists Nearby

Photo of Melissa Fuchs, Clinical Social Work/Therapist, LCSW
Melissa Fuchs
Clinical Social Work/Therapist, LCSW
Online Only
Hello, my name is Melissa Fuchs. I am a Licensed Clinical Social Worker (LCSW) in New York state. I'm someone who finds purpose in supporting others through moments that matter. Professional experiences working with hospice, children in residential care, and adolescents in high school settings have developed my passion and interest in working with people going through life transitions and helping them make sense of how their world has changed.
Hello, my name is Melissa Fuchs. I am a Licensed Clinical Social Worker (LCSW) in New York state. I'm someone who finds purpose in supporting others through moments that matter. Professional experiences working with hospice, children in residential care, and adolescents in high school settings have developed my passion and interest in working with people going through life transitions and helping them make sense of how their world has changed.
(845) 280-3537 View (845) 280-3537
Photo of Diana Rubin, Clinical Social Work/Therapist, LCSW
Diana Rubin
Clinical Social Work/Therapist, LCSW
Online Only
With proven clinical expertise, I know it is never too late to access your innate capacity to heal and make meaningful, desired change—no matter your age. My clients often describe our sessions as a safe place to exhale and find clarity. Whether you’re facing a major transition, persistent stress, or seeking deeper fulfillment, I provide tailored, evidence-based care through telehealth. While I specialize in CBT, I draw from a diverse toolbox of techniques to meet your unique needs. I accept many insurance plans, including Medicare. Please contact me for a free consultation.
With proven clinical expertise, I know it is never too late to access your innate capacity to heal and make meaningful, desired change—no matter your age. My clients often describe our sessions as a safe place to exhale and find clarity. Whether you’re facing a major transition, persistent stress, or seeking deeper fulfillment, I provide tailored, evidence-based care through telehealth. While I specialize in CBT, I draw from a diverse toolbox of techniques to meet your unique needs. I accept many insurance plans, including Medicare. Please contact me for a free consultation.
(845) 345-8182 View (845) 345-8182
Photo of Dr. Carolyn Peguero Spencer, Clinical Social Work/Therapist, PhD, LCSW, CPC
Dr. Carolyn Peguero Spencer
Clinical Social Work/Therapist, PhD, LCSW, CPC
Online Only
Are you feeling stuck and disconnected from yourself? Are you working to change old habits and self-sabotaging behavior? These women's issues can manifest into depression, anxiety, or a state of consistent stress or low self-esteem. Women experience many disruptions during their lifetime and during the creation of their self-hood. It may feel like you have lost yourself and lost your sense of identity. Women also experience an overwhelming sense of emotions. For women of color, the pressure to reconcile racial identity, language, economic disparities, and bi-cultural obligations can create feelings of sadness and powerlessness.
Are you feeling stuck and disconnected from yourself? Are you working to change old habits and self-sabotaging behavior? These women's issues can manifest into depression, anxiety, or a state of consistent stress or low self-esteem. Women experience many disruptions during their lifetime and during the creation of their self-hood. It may feel like you have lost yourself and lost your sense of identity. Women also experience an overwhelming sense of emotions. For women of color, the pressure to reconcile racial identity, language, economic disparities, and bi-cultural obligations can create feelings of sadness and powerlessness.
(347) 321-8904 View (347) 321-8904

See more therapy options for Monticello

How does your Therapist compare?

Number of Therapists in Monticello, NY

10+

Average cost per session

$150

Therapists in Monticello, NY who prioritize treating:

100% Depression
94% Anxiety
94% Social Anxiety
94% Health Anxiety
94% Driving Anxiety
88% Self Esteem
82% Relationship Issues

Average years in practice

14 Years

Top 3 insurances accepted

83% Aetna
75% Cigna and Evernorth
67% Empire Blue Cross Blue Shield

How Therapists in Monticello, NY see their clients

59% Online Only
41% In Person and Online

Gender breakdown

71% Female
29% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Monticello?

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.