Therapists in Portland, OR

View neighborhoods in Portland
Photo of Monica A Geretti, MA, LPC, Licensed Professional Counselor
Monica A Geretti
Licensed Professional Counselor, MA, LPC
Verified Verified
Portland, OR 97203
Life is a journey for all of us and people seek therapy for a variety of reasons. My work is about helping you address whatever challenges are getting in the way of you living as your fullest self. Therapy with me is an active and collaborative exploration of your mostly unconscious internal world- the beliefs and feelings that unknowingly drive you in life. Together we create a space for you to better know and understand yourself so that you can make thoughtful, responsive, and sustainable changes.
Life is a journey for all of us and people seek therapy for a variety of reasons. My work is about helping you address whatever challenges are getting in the way of you living as your fullest self. Therapy with me is an active and collaborative exploration of your mostly unconscious internal world- the beliefs and feelings that unknowingly drive you in life. Together we create a space for you to better know and understand yourself so that you can make thoughtful, responsive, and sustainable changes.
(503) 468-1392 View (503) 468-1392
Photo of Leslie Rodgers, LCSW, Clinical Social Work/Therapist
Leslie Rodgers
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Portland, OR 97202
Are you feeling overwhelmed by the chaos in the world and feeling so numb and shut down that it’s hard to connect with yourself and others? Or maybe you’ve decided it’s time to examine your childhood trauma and address the longstanding thoughts and behavior patterns bringing you suffering? It takes a lot of courageous vulnerability to start a healing journey of self-discovery and self-reclamation. I'm glad you're here and I do believe a life of greater connection and joy is waiting for you!
Are you feeling overwhelmed by the chaos in the world and feeling so numb and shut down that it’s hard to connect with yourself and others? Or maybe you’ve decided it’s time to examine your childhood trauma and address the longstanding thoughts and behavior patterns bringing you suffering? It takes a lot of courageous vulnerability to start a healing journey of self-discovery and self-reclamation. I'm glad you're here and I do believe a life of greater connection and joy is waiting for you!
(503) 454-6178 View (503) 454-6178
Photo of Nancy Moore, MSW, LCSW, CISD, Clinical Social Work/Therapist
Nancy Moore
Clinical Social Work/Therapist, MSW, LCSW, CISD
Verified Verified
2 Endorsed
Portland, OR 97232
Not accepting new clients
I am a dedicated mental health professional and have over twenty years of experience working in mental health. I begin my work by listening to what your goals are for counseling. My goal is simply this ~ to help individuals achieve personal growth and well-being through counseling. Together we will identify your goals, explore thinking patterns and emotional barriers that may prevent you from reaching your fullest potential. My approach is down-to-earth, empowering, and supportive. Because I believe a good therapeutic connection between my client and myself is essential, I routinely offer a free 30-minute consultation.
I am a dedicated mental health professional and have over twenty years of experience working in mental health. I begin my work by listening to what your goals are for counseling. My goal is simply this ~ to help individuals achieve personal growth and well-being through counseling. Together we will identify your goals, explore thinking patterns and emotional barriers that may prevent you from reaching your fullest potential. My approach is down-to-earth, empowering, and supportive. Because I believe a good therapeutic connection between my client and myself is essential, I routinely offer a free 30-minute consultation.
(971) 236-4067 View (971) 236-4067
Photo of Bill Maier - Bill Maier, LCSW, LLC, LCSW, OR11449, LLC, Clinical Social Work/Therapist
Bill Maier, LCSW, LLC
Clinical Social Work/Therapist, LCSW, OR11449, LLC
Verified Verified
Portland, OR 97213  (Online Only)
"When you come into therapy it is a time to expand the sense of yourself. Our job is to get familiar with the values that have helped you get through difficult situations and use them now. You may be a combat veteran, mental health or law enforcement worker having family or relationship problems. You need clear and practical strategies for replacing automatic reactions with mindful responses. Feeling understood by another human being is useful for flexible problem solving and clarifying your values. The majority of my experience is working with Post-Traumatic Stress Disorder. PTSD will definitely get better with knowledgeable treatment."
"When you come into therapy it is a time to expand the sense of yourself. Our job is to get familiar with the values that have helped you get through difficult situations and use them now. You may be a combat veteran, mental health or law enforcement worker having family or relationship problems. You need clear and practical strategies for replacing automatic reactions with mindful responses. Feeling understood by another human being is useful for flexible problem solving and clarifying your values. The majority of my experience is working with Post-Traumatic Stress Disorder. PTSD will definitely get better with knowledgeable treatment."
(503) 832-5987 View (503) 832-5987
Photo of Rachel E. Zavertnik - | Rachel E. Zavertnik | the.irezjoy.method |, LCSW, LICSW, Clinical Social Work/Therapist
| Rachel E. Zavertnik | the.irezjoy.method |
Clinical Social Work/Therapist, LCSW, LICSW
Verified Verified
Portland, OR 97212
I understand how difficult it can be to parent effectively, especially when it comes to improving communication and creating a peaceful home without resorting to yelling, screaming, or empty threats. Mastering positive parenting can be tough and overwhelming. Are you constantly arguing with your child or finding yourself using threats and getting into disagreements? Do you struggle to get your child to help with chores or show respect? I completely understand as I've been in similar situations. It's normal to want to feel in control while leading a balanced and satisfying life.
I understand how difficult it can be to parent effectively, especially when it comes to improving communication and creating a peaceful home without resorting to yelling, screaming, or empty threats. Mastering positive parenting can be tough and overwhelming. Are you constantly arguing with your child or finding yourself using threats and getting into disagreements? Do you struggle to get your child to help with chores or show respect? I completely understand as I've been in similar situations. It's normal to want to feel in control while leading a balanced and satisfying life.
(971) 203-0743 View (971) 203-0743
Photo of Heather Mitchell, LPC, LMHC, Licensed Professional Counselor
Heather Mitchell
Licensed Professional Counselor, LPC, LMHC
Verified Verified
Portland, OR 97202
Waitlist for new clients
Heather is a compassionate guide who listens deeply and accepts you where you’re at. She helps you explore your strengths and limitations within a safe context where your thoughts and emotions can be felt, communicated, and understood. Heather is experienced in working with clients struggling with depression, grief and loss, trauma, anxiety, relationship stress, and personal growth/exploration. She is specialized in helping women who have experienced infertility or loss due to miscarriage & is an Enneagram expert.
Heather is a compassionate guide who listens deeply and accepts you where you’re at. She helps you explore your strengths and limitations within a safe context where your thoughts and emotions can be felt, communicated, and understood. Heather is experienced in working with clients struggling with depression, grief and loss, trauma, anxiety, relationship stress, and personal growth/exploration. She is specialized in helping women who have experienced infertility or loss due to miscarriage & is an Enneagram expert.
(503) 741-2593 View (503) 741-2593
Kenneth L Andert
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Portland, OR 97205
Life and living only exist in the present moment. Our untrained mind often causes us suffering when it dwells on past experiences, or future fears, clouding this moment where living actually occures. Depression, anxiety, our beliefs about our selves and others, all stem from these unnecessary thoughts and their related emotions. Our mind must come to realize that it is the cause of its own unhappiness. Then whatever we experience in life is no longer overwhelming. I have an appreciation and grounding in western oriented psychodynamics enriched with an eastern psychological and Spiritual perspective. Please visit my website: kennethandert.com
Life and living only exist in the present moment. Our untrained mind often causes us suffering when it dwells on past experiences, or future fears, clouding this moment where living actually occures. Depression, anxiety, our beliefs about our selves and others, all stem from these unnecessary thoughts and their related emotions. Our mind must come to realize that it is the cause of its own unhappiness. Then whatever we experience in life is no longer overwhelming. I have an appreciation and grounding in western oriented psychodynamics enriched with an eastern psychological and Spiritual perspective. Please visit my website: kennethandert.com
(971) 236-4240 View (971) 236-4240
Photo of Douglas Mitchell - Douglas Mitchell - Artist Eye Counseling, MS, CRC , NCC
Douglas Mitchell - Artist Eye Counseling
Professional Counselor Associate, MS, CRC , NCC
Verified Verified
1 Endorsed
Portland, OR 97211
Waitlist for new clients
Are you wrestling with trauma, anxiety, or depression? Perhaps you’re navigating the complexities of neurodiversity, such as ADD/ADHD or autism. Whatever your unique challenges, I’m here to guide you toward healing and self-discovery.
Are you wrestling with trauma, anxiety, or depression? Perhaps you’re navigating the complexities of neurodiversity, such as ADD/ADHD or autism. Whatever your unique challenges, I’m here to guide you toward healing and self-discovery.
View
Photo of Angie Arledge, CSWA, SWA
Angie Arledge
Clinical Social Work Associate, CSWA, SWA
Verified Verified
Portland, OR 97227  (Online Only)
Currently Taking New Clients in Oregon and Washington states. My passion is to walk alongside individuals to support them in finding their strengths. I am compassionate and will meet you where you are at. I think that self-investing and community care are essential to our mental wellness, and together I will walk alongside you on your journey of finding that contentment you are searching for. I will provide a safe, non-judgmental space for you to process through and collaborate in finding those safe coping strategies to achieve your goals.
Currently Taking New Clients in Oregon and Washington states. My passion is to walk alongside individuals to support them in finding their strengths. I am compassionate and will meet you where you are at. I think that self-investing and community care are essential to our mental wellness, and together I will walk alongside you on your journey of finding that contentment you are searching for. I will provide a safe, non-judgmental space for you to process through and collaborate in finding those safe coping strategies to achieve your goals.
(971) 232-3430 View (971) 232-3430
Photo of Tony Lash, MA, Licensed Professional Counselor
Tony Lash
Licensed Professional Counselor, MA
Verified Verified
3 Endorsed
Portland, OR 97202
I love working with diverse people from a variety of backgrounds. My focus is not only on your personal growth, but also on improving your relationships with romantic partners, family members, and friends. I also love helping couples end negative cycles, heal wounds, and deepen connection. My background as a professional musician and record producer also allows me a deep understanding of issues faced by creative people, including tension between creative drive and other commitments, struggles with creative partners, and feeling unfulfilled when your creative energy is drained by your day job.
I love working with diverse people from a variety of backgrounds. My focus is not only on your personal growth, but also on improving your relationships with romantic partners, family members, and friends. I also love helping couples end negative cycles, heal wounds, and deepen connection. My background as a professional musician and record producer also allows me a deep understanding of issues faced by creative people, including tension between creative drive and other commitments, struggles with creative partners, and feeling unfulfilled when your creative energy is drained by your day job.
(503) 974-0662 View (503) 974-0662
Photo of Brian Bracelin - Ashling Clinical, LCSW, Clinical Social Work/Therapist
Ashling Clinical
Clinical Social Work/Therapist, LCSW
Verified Verified
Portland, OR 97215  (Online Only)
Living the best version of you is difficult when you are experiencing anxiety and depression from past experiences. Coming home stressed after your day and not being present to those you love can add to this struggle. Waking up rested, being confident and at peace when you walk through your door in the evening is what you deserve. Discovering new directions for yourself is a path I can support you on. Reaching out to a professional is a great first step to start your journey in being supportable & living the life you want on your terms.
Living the best version of you is difficult when you are experiencing anxiety and depression from past experiences. Coming home stressed after your day and not being present to those you love can add to this struggle. Waking up rested, being confident and at peace when you walk through your door in the evening is what you deserve. Discovering new directions for yourself is a path I can support you on. Reaching out to a professional is a great first step to start your journey in being supportable & living the life you want on your terms.
(503) 836-8559 View (503) 836-8559
Photo of Anna Lisa Couturier, LCSW, CADCI, Clinical Social Work/Therapist
Anna Lisa Couturier
Clinical Social Work/Therapist, LCSW, CADCI
Verified Verified
2 Endorsed
Portland, OR 97232
Waitlist for new clients
My approach to counseling is centered on building a relationship with youth and families, adults, and couples that is based on dignity and mutual respect. I attempt to create an atmosphere of cooperation and equality in counseling, based on the belief that clients are the experts on their own lives and experiences, and that this expertise can be utilized in the process of making change. I believe compassion and authenticity are essential to forging a strong therapeutic relationship.
My approach to counseling is centered on building a relationship with youth and families, adults, and couples that is based on dignity and mutual respect. I attempt to create an atmosphere of cooperation and equality in counseling, based on the belief that clients are the experts on their own lives and experiences, and that this expertise can be utilized in the process of making change. I believe compassion and authenticity are essential to forging a strong therapeutic relationship.
(503) 451-6068 View (503) 451-6068
Photo of Derica R Waller, MSW, LCSW, Clinical Social Work/Therapist
Derica R Waller
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Portland, OR 97214  (Online Only)
Not accepting new clients
Are you ready for a change? Are you feeling stuck in the same patterns and stress over and over? You are more powerful than you know. I specialize in doing personal growth work that can help you discover what makes you truly happy. Find freedom from old anxieties, unfinished grief, old habits and past hurts. I can support you to learn to live from a place of energy, joy and intention. Together we can create the change you want and manage the fears, barriers and uncertainties that come up along the way.
Are you ready for a change? Are you feeling stuck in the same patterns and stress over and over? You are more powerful than you know. I specialize in doing personal growth work that can help you discover what makes you truly happy. Find freedom from old anxieties, unfinished grief, old habits and past hurts. I can support you to learn to live from a place of energy, joy and intention. Together we can create the change you want and manage the fears, barriers and uncertainties that come up along the way.
(503) 486-4275 View (503) 486-4275
Photo of Mackenzie Phelps, MA, Marriage & Family Therapist Associate
Mackenzie Phelps
Marriage & Family Therapist Associate, MA
Verified Verified
Portland, OR 97219
I am passionate about supporting individuals across the lifespan, including adolescents, teens, young adults, pre-marital couples, families, and LGBTQIA+ clients. I do not work with couples navigating separation at this time. My areas of practice include life transitions, stress and anxiety management, communication, self-esteem, empowerment, and the intersection of faith/spirituality with mental health.
I am passionate about supporting individuals across the lifespan, including adolescents, teens, young adults, pre-marital couples, families, and LGBTQIA+ clients. I do not work with couples navigating separation at this time. My areas of practice include life transitions, stress and anxiety management, communication, self-esteem, empowerment, and the intersection of faith/spirituality with mental health.
(971) 999-2763 View (971) 999-2763
Photo of Sharon Elwood, MA, LPC, Licensed Professional Counselor
Sharon Elwood
Licensed Professional Counselor, MA, LPC
Verified Verified
Portland, OR 97210
I work within a wide range of therapy issues. If you are suffering in an unsatisfying relationship or career, or are hungry to understand yourself better therapy can be beneficial. By utilizing the therapeutic skills I've developed you may find hope and possibly a shift in perspective. Feeling better is possible. I bring a supportive approach and have enormous compassion for the human experience, life can be difficult. I offer Telehealth or in person therapy sessions.
I work within a wide range of therapy issues. If you are suffering in an unsatisfying relationship or career, or are hungry to understand yourself better therapy can be beneficial. By utilizing the therapeutic skills I've developed you may find hope and possibly a shift in perspective. Feeling better is possible. I bring a supportive approach and have enormous compassion for the human experience, life can be difficult. I offer Telehealth or in person therapy sessions.
(971) 236-5161 View (971) 236-5161
Photo of Greg Campanile, QMHP, Pre-Licensed Professional
Greg Campanile
Pre-Licensed Professional, QMHP
Verified Verified
Portland, OR 97205
Therapy can be a place to connect with what is most important in life. My goal is to create a space where you can work through life's challenges, uncover inner strengths, and learn to develop a deeper inner trust. My approach prioritizes creating a therapeutic relationship with my clients as the basis for using interventions from Internal Family Systems and psychodynamic therapies. I work to facilitate a space that feels safe for my clients to explore and heal parts of themselves that may be keeping them stuck, and to move forward in a way that feels authentic and congruent with the client’s goals.
Therapy can be a place to connect with what is most important in life. My goal is to create a space where you can work through life's challenges, uncover inner strengths, and learn to develop a deeper inner trust. My approach prioritizes creating a therapeutic relationship with my clients as the basis for using interventions from Internal Family Systems and psychodynamic therapies. I work to facilitate a space that feels safe for my clients to explore and heal parts of themselves that may be keeping them stuck, and to move forward in a way that feels authentic and congruent with the client’s goals.
(971) 315-4951 View (971) 315-4951
Photo of Misty Stronk, LCSW, Clinical Social Work/Therapist
Misty Stronk
Clinical Social Work/Therapist, LCSW
Verified Verified
Portland, OR 97266  (Online Only)
Waitlist for new clients
Just as many pieces make up the whole of a person's life, there are many components make up a successful experience with counseling. The therapeutic journey begins from a place of trust and support. I meet my clients where they are at and my goal for therapy is to provide a safe space for my clients to process through the necessary emotions to reach their next goal. I am passionate about serving all individuals who wish seek guidance, a place to be vulnerable and the opportunity to grow. I work with teens, emerging adults and adult clients of any population.
Just as many pieces make up the whole of a person's life, there are many components make up a successful experience with counseling. The therapeutic journey begins from a place of trust and support. I meet my clients where they are at and my goal for therapy is to provide a safe space for my clients to process through the necessary emotions to reach their next goal. I am passionate about serving all individuals who wish seek guidance, a place to be vulnerable and the opportunity to grow. I work with teens, emerging adults and adult clients of any population.
(503) 743-7721 x9059 View (503) 743-7721 x9059
Photo of Dr. Dianna Harris (Accepting New Clients), PsyD, PMHNP, Psychologist
Dr. Dianna Harris (Accepting New Clients)
Psychologist, PsyD, PMHNP
Verified Verified
Portland, OR 97229
Accepting NEW Clients (ages 18-65) as of 7/16/24 for Medication Management (I am not taking clients for therapy). Appointments are available in 2 weeks. Complete the Patient Inquiry Form on my website. You will receive a response the same or next day. My practice is primarily composed of adults struggling with anxiety and depression. I find that people reach out to treatment when excessive worry, low motivation, and negative thinking can lead to feeling less confident in their work, behind on tasks at home, and impacting their relationships. I don't treat ADHD and I don't prescribe controlled substances, such as Xanax for anxiety.
Accepting NEW Clients (ages 18-65) as of 7/16/24 for Medication Management (I am not taking clients for therapy). Appointments are available in 2 weeks. Complete the Patient Inquiry Form on my website. You will receive a response the same or next day. My practice is primarily composed of adults struggling with anxiety and depression. I find that people reach out to treatment when excessive worry, low motivation, and negative thinking can lead to feeling less confident in their work, behind on tasks at home, and impacting their relationships. I don't treat ADHD and I don't prescribe controlled substances, such as Xanax for anxiety.
(971) 606-4749 View (971) 606-4749
Photo of J Renee Tate, PsyD, Psychologist
J Renee Tate
Psychologist, PsyD
Verified Verified
Portland, OR 97214
I am a licensed psychologist based in Portland, Oregon with a primary focus in evaluation and assessment. I also conduct individual psychotherapy for adults, particularly those adjusting to medical diagnoses. I periodically run groups for caregivers about managing the cognitive and emotional effects of strokes and brain injuries, drawing on current research and my history working in a rehabilitation unit.
I am a licensed psychologist based in Portland, Oregon with a primary focus in evaluation and assessment. I also conduct individual psychotherapy for adults, particularly those adjusting to medical diagnoses. I periodically run groups for caregivers about managing the cognitive and emotional effects of strokes and brain injuries, drawing on current research and my history working in a rehabilitation unit.
(503) 217-6990 View (503) 217-6990
Photo of Sharon O'Brien, LPC, Licensed Professional Counselor
Sharon O'Brien
Licensed Professional Counselor, LPC
Verified Verified
Portland, OR 97209  (Online Only)
Are you getting what you want out of life? I help my clients identify and let go of negative feelings, old behavior patterns, and ways of thinking that prevent them from living the life they want. Counseling can help you experience the joy of self-acceptance and the peace of mind that comes with healthy self-esteem. In the process, you can create stronger relationships, improve your communication with others, and see new possibilities for your life.
Are you getting what you want out of life? I help my clients identify and let go of negative feelings, old behavior patterns, and ways of thinking that prevent them from living the life they want. Counseling can help you experience the joy of self-acceptance and the peace of mind that comes with healthy self-esteem. In the process, you can create stronger relationships, improve your communication with others, and see new possibilities for your life.
(971) 233-6273 View (971) 233-6273
1
...

How does your Therapist compare?

Number of Therapists in Portland, OR

3,000+

Average cost per session

$160

Therapists in Portland, OR who prioritize treating:

91% Anxiety
84% Depression
77% Relationship Issues
75% Self Esteem
73% Trauma and PTSD
70% Stress
67% Life Transitions

Average years in practice

10 Years

Top 3 insurances accepted

53% PacificSource
48% Aetna
38% BlueCross and BlueShield

How Therapists in Portland, OR see their clients

55% In Person and Online
45% Online Only

Gender breakdown

75% Female
21% Male
4% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Portland?

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.