Therapists in Selden, NY

Photo of Ellen Jones, LCSW, Clinical Social Work/Therapist
Ellen Jones
Clinical Social Work/Therapist, LCSW
Verified Verified
Selden, NY 11784  (Online Only)
Hello! Thank you for visiting my Path profile. I am Ellen Jones, LCSW; a Licensed Clinical Social Worker in the state of New York with over 20 years of experience in mental health. I graduated with a Doctorate of Social Work from Capella University, a Master of Social Work from Marywood University, and an undergraduate degree from the State University of NY-Suny Empire. My experience as a social worker encompasses ages from 5 to 99 years old. I have diverse experience in a variety of treatment settings.
Hello! Thank you for visiting my Path profile. I am Ellen Jones, LCSW; a Licensed Clinical Social Worker in the state of New York with over 20 years of experience in mental health. I graduated with a Doctorate of Social Work from Capella University, a Master of Social Work from Marywood University, and an undergraduate degree from the State University of NY-Suny Empire. My experience as a social worker encompasses ages from 5 to 99 years old. I have diverse experience in a variety of treatment settings.
(929) 822-4545 View (929) 822-4545
Photo of Virginia L. Medina-Lomas, LCSW-R, Clinical Social Work/Therapist
Virginia L. Medina-Lomas
Clinical Social Work/Therapist, LCSW-R
Verified Verified
Selden, NY 11784
Virginia speaks English and Spanish, she looks forward to helping you express your life's journey and assisting you in developing productive ways to handle depression, stress, anxiety, disappointments and trauma. As needed Spiritual Mentoring is offered since Virginia is an Ordained Minister under the Order of Melchizedek. Please be aware that I do not accept criminal, custody and do not accept CPS court cases.
Virginia speaks English and Spanish, she looks forward to helping you express your life's journey and assisting you in developing productive ways to handle depression, stress, anxiety, disappointments and trauma. As needed Spiritual Mentoring is offered since Virginia is an Ordained Minister under the Order of Melchizedek. Please be aware that I do not accept criminal, custody and do not accept CPS court cases.
(631) 993-4107 View (631) 993-4107
Photo of Jennifer Vetter, LCSW, Clinical Social Work/Therapist
Jennifer Vetter
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Selden, NY 11784  (Online Only)
Compassionate therapist experienced with all age groups and diverse backgrounds. I am able to develop strong connections quickly, with adolescents as well as older generations. Active involvement in the community as a facilitator and advocate provides me with an awareness and knowledge for all challenges in life that impact mental health.
Compassionate therapist experienced with all age groups and diverse backgrounds. I am able to develop strong connections quickly, with adolescents as well as older generations. Active involvement in the community as a facilitator and advocate provides me with an awareness and knowledge for all challenges in life that impact mental health.
(631) 496-4201 View (631) 496-4201
Photo of Lauren Lara, LCSW, Clinical Social Work/Therapist
Lauren Lara
Clinical Social Work/Therapist, LCSW
Verified Verified
Selden, NY 11784  (Online Only)
Waitlist for new clients
Therapy can be a scary undertaking, but I am here to offer a safe and non-judgmental environment in order to work together towards developing treatment goals. I understand that depression, anxiety, ADHD, OCD, low self-esteem and self-harm can impact daily functioning. We will work together to explore emotions and develop new and effective coping strategies. Working on improving communication skills and boundary setting can make a big difference!
Therapy can be a scary undertaking, but I am here to offer a safe and non-judgmental environment in order to work together towards developing treatment goals. I understand that depression, anxiety, ADHD, OCD, low self-esteem and self-harm can impact daily functioning. We will work together to explore emotions and develop new and effective coping strategies. Working on improving communication skills and boundary setting can make a big difference!
(631) 920-4174 View (631) 920-4174
Photo of Jerra Lynn Juliano, LCSW, Clinical Social Work/Therapist
Jerra Lynn Juliano
Clinical Social Work/Therapist, LCSW
Verified Verified
Selden, NY 11784  (Online Only)
"The best way out is always through." You may have noticed the same painful themes keep replaying in your life but you can't seem to find the stop button. Your world is constantly moving & changing before you can even catch your breath. Perhaps you are experiencing conflict with a son, daughter, parent, or spouse and it is taking its toll on you. Maybe you have experiences that you don't quite understand or don't express for fear of being judged or deemed "insane". Maybe you just feel alone, misunderstood or lost. If so, I am here to help you.
"The best way out is always through." You may have noticed the same painful themes keep replaying in your life but you can't seem to find the stop button. Your world is constantly moving & changing before you can even catch your breath. Perhaps you are experiencing conflict with a son, daughter, parent, or spouse and it is taking its toll on you. Maybe you have experiences that you don't quite understand or don't express for fear of being judged or deemed "insane". Maybe you just feel alone, misunderstood or lost. If so, I am here to help you.
(516) 550-3073 View (516) 550-3073
Photo of Elizabeth Fusaro, LCSW, Clinical Social Work/Therapist
Elizabeth Fusaro
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Selden, NY 11784  (Online Only)
"Breathe. You're going to be okay. This will pass & you will survive." - The first step is often the hardest & yet you've found your way here & I am so proud of you. If you are considering therapy, you have already begun the journey of introspection & are one step closer to finding the serenity you seek. This is your journey & I am here to provide support, guidance, & psychoeducation along the way while assisting you in gaining insight & self-awareness. We are all capable of change and self-improvement. I am here to assist you in exploring the tools necessary to make that change happen.
"Breathe. You're going to be okay. This will pass & you will survive." - The first step is often the hardest & yet you've found your way here & I am so proud of you. If you are considering therapy, you have already begun the journey of introspection & are one step closer to finding the serenity you seek. This is your journey & I am here to provide support, guidance, & psychoeducation along the way while assisting you in gaining insight & self-awareness. We are all capable of change and self-improvement. I am here to assist you in exploring the tools necessary to make that change happen.
(631) 791-6781 View (631) 791-6781
Photo of Michelle Fowler, LMSW, MBA, EdD, Clinical Social Work/Therapist
Michelle Fowler
Clinical Social Work/Therapist, LMSW, MBA, EdD
Verified Verified
Selden, NY 11784
It is not always easy to find the perfect therapist. I pride myself in being trustworthy, empathic and culturally competent. If you are suffering from anxiety, you want to understand why and how to control and manage the anxiety. If you are suffering from depression, you want to feel good and excited, the feeling of wanting to live and have a wonderful life. If you are victim of abuse you need assistance and a safe place, we can work on it together. If you have mental health issues such as bipolar, schizophrenia I have been trained to help you with coping skills and manage your symptoms.
It is not always easy to find the perfect therapist. I pride myself in being trustworthy, empathic and culturally competent. If you are suffering from anxiety, you want to understand why and how to control and manage the anxiety. If you are suffering from depression, you want to feel good and excited, the feeling of wanting to live and have a wonderful life. If you are victim of abuse you need assistance and a safe place, we can work on it together. If you have mental health issues such as bipolar, schizophrenia I have been trained to help you with coping skills and manage your symptoms.
(631) 253-8091 View (631) 253-8091
Photo of Jennifer Simmons, LCSW, Clinical Social Work/Therapist
Jennifer Simmons
Clinical Social Work/Therapist, LCSW
Verified Verified
2 Endorsed
Selden, NY 11784  (Online Only)
I work best with women who experience anxiety, depression and struggle to focus on their own needs. Problem areas may include becoming explosive or frustrated toward those you love and having difficulty changing your emotional reactions no matter how hard you try. You may feel like your life is not headed in the direction you would like it to go. Common concerns include anger and rage, resentment, not feeling like yourself and feeling as though you can’t keep it together like “all the other moms.”
I work best with women who experience anxiety, depression and struggle to focus on their own needs. Problem areas may include becoming explosive or frustrated toward those you love and having difficulty changing your emotional reactions no matter how hard you try. You may feel like your life is not headed in the direction you would like it to go. Common concerns include anger and rage, resentment, not feeling like yourself and feeling as though you can’t keep it together like “all the other moms.”
(516) 586-0499 View (516) 586-0499
Photo of Pauline Urick, Clinical Social Work/Therapist
Pauline Urick
Clinical Social Work/Therapist
Verified Verified
Selden, NY 11784  (Online Only)
Pauline Urick holds a Master’s degree in Social Work from Adelphi University. Pauline is a Licensed Clinical Social Worker who brings a wealth of knowledge and experience to our center. She has experience with the ID/DD population, medically complex, end of life, severely mentally ill as well as young children. Pauline has a passion for counseling and assisting at risk populations that are most vulnerable. Pauline enjoys spending time with family, traveling, reading, and going to Disney World.
Pauline Urick holds a Master’s degree in Social Work from Adelphi University. Pauline is a Licensed Clinical Social Worker who brings a wealth of knowledge and experience to our center. She has experience with the ID/DD population, medically complex, end of life, severely mentally ill as well as young children. Pauline has a passion for counseling and assisting at risk populations that are most vulnerable. Pauline enjoys spending time with family, traveling, reading, and going to Disney World.
(631) 837-2485 View (631) 837-2485
Photo of Joseph Patrick Iannotto, LCSW, Clinical Social Work/Therapist
Joseph Patrick Iannotto
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Selden, NY 11784  (Online Only)
I worked with teens, young adults, older adults and couples. I have experience in helping clients with stress and anxiety, lgbtq+ related issues, relationship issues & family conflicts. I work with my clients to create an open and safe environment where thoughts and feelings can be shared without fear of judgment. Taking the first step to seeking a more fulfilling and happier life takes courage. I am here to support you in this process.
I worked with teens, young adults, older adults and couples. I have experience in helping clients with stress and anxiety, lgbtq+ related issues, relationship issues & family conflicts. I work with my clients to create an open and safe environment where thoughts and feelings can be shared without fear of judgment. Taking the first step to seeking a more fulfilling and happier life takes courage. I am here to support you in this process.
(631) 900-2767 View (631) 900-2767
Photo of Ashley Stock, LMHC, MS, C-DBT
Ashley Stock
Mental Health Counselor, LMHC, MS, C-DBT
Verified Verified
Selden, NY 11784  (Online Only)
Hello there and welcome! My name is Ashley and I have over 10 years of experience in the mental health field. I enjoy working with young adults, parents, and women. I specialize in anxiety, depression, stress, parenting, relationships, and self-esteem. I also enjoy working with women who are pregnant or postpartum and trying to navigate life before or after baby. Having proper support during these times is crucial and often times overlooked. My services provide clients with the guidance they need to live life to the fullest.
Hello there and welcome! My name is Ashley and I have over 10 years of experience in the mental health field. I enjoy working with young adults, parents, and women. I specialize in anxiety, depression, stress, parenting, relationships, and self-esteem. I also enjoy working with women who are pregnant or postpartum and trying to navigate life before or after baby. Having proper support during these times is crucial and often times overlooked. My services provide clients with the guidance they need to live life to the fullest.
(631) 743-6132 View (631) 743-6132
Photo of Danielle LaGrandier, MA, LCAT, ATR-BC, Art Therapist
Danielle LaGrandier
Art Therapist, MA, LCAT, ATR-BC
Verified Verified
1 Endorsed
Selden, NY 11784  (Online Only)
We all encounter wounds from different phases of life, relationships and traumas. However, we aren’t always taught the tools that offer us resolution and healing. We are conditioned to be victimized by this pain rather than transforming it for a greater purpose. I believe when we integrate using our gifts towards life’s challenges and fully embrace the darkness within us, we can use it to our advantage, turning our pain into purpose.
We all encounter wounds from different phases of life, relationships and traumas. However, we aren’t always taught the tools that offer us resolution and healing. We are conditioned to be victimized by this pain rather than transforming it for a greater purpose. I believe when we integrate using our gifts towards life’s challenges and fully embrace the darkness within us, we can use it to our advantage, turning our pain into purpose.
(516) 774-2534 View (516) 774-2534
Photo of Jacqueline McNally, LCAT, BC-DMT, MS
Jacqueline McNally
LCAT, BC-DMT, MS
Verified Verified
1 Endorsed
Selden, NY 11784
I work with clients who have varying struggles from anxiety, body image, depression and life transitions. Our daily struggles are held within our body and impact everything from daily functioning, relationships to how we take up space in our environment. As a dance/movement therapist I will utilize body based interventions (ex. breathing, imagery and metaphor) to assist in exploring how your body holds onto symptoms. Through the interconnectedness of body, mind and spirit you can explore how to shift to allow daily life to become more manageable and enjoyable.
I work with clients who have varying struggles from anxiety, body image, depression and life transitions. Our daily struggles are held within our body and impact everything from daily functioning, relationships to how we take up space in our environment. As a dance/movement therapist I will utilize body based interventions (ex. breathing, imagery and metaphor) to assist in exploring how your body holds onto symptoms. Through the interconnectedness of body, mind and spirit you can explore how to shift to allow daily life to become more manageable and enjoyable.
(845) 714-0738 View (845) 714-0738
Photo of Lindsay Reynolds, LCAT, ATR-BC, Art Therapist
Lindsay Reynolds
Art Therapist, LCAT, ATR-BC
Verified Verified
Selden, NY 11784
My clients are adults have experienced or are currently going through life challenges such as: surgery or illness, grief & loss (passing of a loved one, divorce, breakup, moving, chronic illness, etc.) a traumatic experience or childhood trauma, mood regulation (anxiety, depression, resentment, etc.), social or communication conflict (family dynamics, friendship or relationship, work stress, etc.) and building their identity. I help people who have been avoiding or "dissociating" but now want to understand their emotions and feelings more deeply.
My clients are adults have experienced or are currently going through life challenges such as: surgery or illness, grief & loss (passing of a loved one, divorce, breakup, moving, chronic illness, etc.) a traumatic experience or childhood trauma, mood regulation (anxiety, depression, resentment, etc.), social or communication conflict (family dynamics, friendship or relationship, work stress, etc.) and building their identity. I help people who have been avoiding or "dissociating" but now want to understand their emotions and feelings more deeply.
(631) 892-2387 View (631) 892-2387
Photo of Kristin Amber Scher, LCSW, Clinical Social Work/Therapist
Kristin Amber Scher
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Selden, NY 11784
Waitlist for new clients
Our thoughts have the ability to impact the quality of our life. "Change your thoughts and you change your world" Norman Vincent Peale. Through Cognitive Behavioral Therapy, we will focus on solutions, challenge distorted thinking and work towards changing destructive patterns of behavior. As a psychotherapist, I will assist you in achieving your goals and work with you to establish positive coping mechanisms to help manage your symptoms.
Our thoughts have the ability to impact the quality of our life. "Change your thoughts and you change your world" Norman Vincent Peale. Through Cognitive Behavioral Therapy, we will focus on solutions, challenge distorted thinking and work towards changing destructive patterns of behavior. As a psychotherapist, I will assist you in achieving your goals and work with you to establish positive coping mechanisms to help manage your symptoms.
(516) 226-7620 View (516) 226-7620
Photo of Diane Seaman, LCSW, BCD, Clinical Social Work/Therapist
Diane Seaman
Clinical Social Work/Therapist, LCSW, BCD
Verified Verified
Selden, NY 11784
I am pleased to address everyone via this network. Over the years I have done a great deal of positive work with, individuals,couples diversified groups, drug and alcohol, children, the elderly, and women/womens issues. I do pre and post operative assessments for gastric bypass individuals. My practice is dedicated to maximizing the individuals I work with in all areas of their life, to produce absolute positivity and eliminate negative behaviors/conflicts. I practive from a cognitive point of view. I welcome all persons and take medicare and most forms of insurance.
I am pleased to address everyone via this network. Over the years I have done a great deal of positive work with, individuals,couples diversified groups, drug and alcohol, children, the elderly, and women/womens issues. I do pre and post operative assessments for gastric bypass individuals. My practice is dedicated to maximizing the individuals I work with in all areas of their life, to produce absolute positivity and eliminate negative behaviors/conflicts. I practive from a cognitive point of view. I welcome all persons and take medicare and most forms of insurance.
(631) 648-7689 View (631) 648-7689
Photo of Marie Carmino, MS, LMHC, Counselor
Marie Carmino
Counselor, MS, LMHC
Verified Verified
Selden, NY 11784
I believe that each of us has the ability to take the necessary steps to bring about positive changes in our lives. As a trained professional Licensed Mental Health Counselor, I will help guide you on that journey. We will work together as I help you learn how to overcome your difficulties by changing your thinking, behavior, and emotional responses. Using CBT, I will focus on teaching you specific techniques and tools that have been shown to be effective in the treatment of many issues, including depression, anxiety, and anger management, just to name a few.
I believe that each of us has the ability to take the necessary steps to bring about positive changes in our lives. As a trained professional Licensed Mental Health Counselor, I will help guide you on that journey. We will work together as I help you learn how to overcome your difficulties by changing your thinking, behavior, and emotional responses. Using CBT, I will focus on teaching you specific techniques and tools that have been shown to be effective in the treatment of many issues, including depression, anxiety, and anger management, just to name a few.
(631) 419-7229 View (631) 419-7229
Photo of Erin Wadington, LMHC, Counselor
Erin Wadington
Counselor, LMHC
Verified Verified
Selden, NY 11784
Throughout life we all face challenges. Whether it's life circumstances, unexpected or anticipated stress, traumatic events and loss, internal or relationship conflict, social or medical stressors, emotional pain and sadness, low self-worth, or family conflict, seeking help is a step towards feeling happier and at peace. Although we don't always have control of the events in our lives, we can choose how to handle them. I offer counseling services for children, tweens, adolescents, and adults.
Throughout life we all face challenges. Whether it's life circumstances, unexpected or anticipated stress, traumatic events and loss, internal or relationship conflict, social or medical stressors, emotional pain and sadness, low self-worth, or family conflict, seeking help is a step towards feeling happier and at peace. Although we don't always have control of the events in our lives, we can choose how to handle them. I offer counseling services for children, tweens, adolescents, and adults.
(631) 485-5148 View (631) 485-5148
Photo of Michelle Conelli, LMFT, LCSW-R, RPT, Marriage & Family Therapist
Michelle Conelli
Marriage & Family Therapist, LMFT, LCSW-R, RPT
Verified Verified
Selden, NY 11784
Waitlist for new clients
If you are experiencing a major life crisis, a stressful situation, or a significant loss or transition, it can be helpful to have an experienced professional to help you cope through life's challenges. I have been practicing individual, couples, and family therapy for 30 years. I am owner and clinical director of Lighthouse Integrative Counseling Services, PLLC, where it is our mission to provide high-quality mental health services that are affordable and accessible. Our staff is well-trained with decades of experience helping clients of all ages. Please visit us at: www.lighthouse-counseling.us for more information.
If you are experiencing a major life crisis, a stressful situation, or a significant loss or transition, it can be helpful to have an experienced professional to help you cope through life's challenges. I have been practicing individual, couples, and family therapy for 30 years. I am owner and clinical director of Lighthouse Integrative Counseling Services, PLLC, where it is our mission to provide high-quality mental health services that are affordable and accessible. Our staff is well-trained with decades of experience helping clients of all ages. Please visit us at: www.lighthouse-counseling.us for more information.
(631) 406-4872 View (631) 406-4872
Photo of Amie Shapiro-Markowitz, LCSW, Clinical Social Work/Therapist
Amie Shapiro-Markowitz
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Selden, NY 11784
I am a Licensed Clinical Social worker with over 15 years of personal and professional experience in the Social Work Field. I think that it is extremely important that my clients feel safe and comfortable and be able to utilize therapy in a way that works for them. For this reason, my practice is online based, using video, phone and real time text messaging. This way you will not have to worry about taking time to travel to and from a session, or remembering what you wanted to discuss in between sessions. I use completely confidential HIPPA compliant software to make therapy something that is safe, comfortable and convenient.
I am a Licensed Clinical Social worker with over 15 years of personal and professional experience in the Social Work Field. I think that it is extremely important that my clients feel safe and comfortable and be able to utilize therapy in a way that works for them. For this reason, my practice is online based, using video, phone and real time text messaging. This way you will not have to worry about taking time to travel to and from a session, or remembering what you wanted to discuss in between sessions. I use completely confidential HIPPA compliant software to make therapy something that is safe, comfortable and convenient.
(631) 212-2456 View (631) 212-2456
1

See more therapy options for Selden

How does your Therapist compare?

Number of Therapists in Selden, NY

30+

Average cost per session

$125

Therapists in Selden, NY who prioritize treating:

97% Anxiety
94% Depression
77% Relationship Issues
77% Coping Skills
74% Self Esteem
68% Family Conflict
65% Stress

Average years in practice

9 Years

Top 3 insurances accepted

81% Aetna
81% Cigna and Evernorth
70% UnitedHealthcare UHC | UBH

How Therapists in Selden, NY see their clients

55% In Person and Online
45% Online Only

Gender breakdown

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

How can I find a therapist in Selden?

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.