Therapists in Piedmont, Portland, OR

Photo of Liam Woods, Marriage & Family Therapist Associate, MA, MFAD
Liam Woods
Marriage & Family Therapist Associate, MA, MFAD
1 Endorsed
Piedmont, Portland, OR 97211
I work with individuals and couples who seek to heal trauma, improve communication, and learn from their emotions through body-based (somatic) practices. If you're feeling anxious, depressed, or isolated without understanding how your body's sensations and emotions can help lead you to greater ease, you are not alone. Our culture has taught us to ignore our bodies rather than listen to them. I specialize in a somatic approach, which complements my other focus areas such as ecotherapy, attachment, parts work, psychedelic integration, and couples therapy.
I work with individuals and couples who seek to heal trauma, improve communication, and learn from their emotions through body-based (somatic) practices. If you're feeling anxious, depressed, or isolated without understanding how your body's sensations and emotions can help lead you to greater ease, you are not alone. Our culture has taught us to ignore our bodies rather than listen to them. I specialize in a somatic approach, which complements my other focus areas such as ecotherapy, attachment, parts work, psychedelic integration, and couples therapy.
(971) 251-4971 View (971) 251-4971
Photo of Sarah K Small, Licensed Professional Counselor, MA, LPC
Sarah K Small
Licensed Professional Counselor, MA, LPC
1 Endorsed
Piedmont, Portland, OR 97219
Do you feel anxious too much of the time? Exhausted, disconnected, without purpose or interest? Do you forfeit your own thoughts and feelings in relationship to others? Would you like to deal with difficulties more effectively than the unconscious impulses to comply, defy or flee? Whether it's a distinct problem or a vague discontent that needs resolution, I hold the space to illuminate, guide and empower your progression. This is where talk is strong medicine. Neuroscience reveals that therapy changes brain chemistry & structure. Habitual patterns fall away to a renewed sense of energy, choice and personal authority.
Do you feel anxious too much of the time? Exhausted, disconnected, without purpose or interest? Do you forfeit your own thoughts and feelings in relationship to others? Would you like to deal with difficulties more effectively than the unconscious impulses to comply, defy or flee? Whether it's a distinct problem or a vague discontent that needs resolution, I hold the space to illuminate, guide and empower your progression. This is where talk is strong medicine. Neuroscience reveals that therapy changes brain chemistry & structure. Habitual patterns fall away to a renewed sense of energy, choice and personal authority.
(503) 967-3168 View (503) 967-3168
Photo of Jay Hopkins, Licensed Professional Counselor, MA, LPC
Jay Hopkins
Licensed Professional Counselor, MA, LPC
Piedmont, Portland, OR 97217
We all get stuck sometimes; and we suffer. Life often feels messy and chaotic, and in the midst of "the daily grind" we experience ourselves as unbalanced, fragmented, and "all over the place." Life is perpetually full of transition and change; and our habituated ways of being in the world are often at odds with the ebb and flow of life's events, and we experience stress, conflict and pain. Despite our resources, strategies and efforts to cope with challenges, we often get stuck; and end up feeling dissatisfied with ourselves, disenchanted with others, and disconnected from life, vitality, joy.
We all get stuck sometimes; and we suffer. Life often feels messy and chaotic, and in the midst of "the daily grind" we experience ourselves as unbalanced, fragmented, and "all over the place." Life is perpetually full of transition and change; and our habituated ways of being in the world are often at odds with the ebb and flow of life's events, and we experience stress, conflict and pain. Despite our resources, strategies and efforts to cope with challenges, we often get stuck; and end up feeling dissatisfied with ourselves, disenchanted with others, and disconnected from life, vitality, joy.
(971) 715-2572 View (971) 715-2572
Photo of Kate Doherty, Clinical Social Work/Therapist, LCSW
Kate Doherty
Clinical Social Work/Therapist, LCSW
Piedmont, Portland, OR 97217
You might be feeling anxious, weighed down by grief, stuck in old patterns, or wondering how to shift your relationship with alcohol or other substances. I’m here to help. I bring 17 years of experience supporting people through life’s challenges — big and small — with compassion and practical tools. Together, we’ll use Internal Family Systems and other evidence-based approaches to create a path that feels right for you.
You might be feeling anxious, weighed down by grief, stuck in old patterns, or wondering how to shift your relationship with alcohol or other substances. I’m here to help. I bring 17 years of experience supporting people through life’s challenges — big and small — with compassion and practical tools. Together, we’ll use Internal Family Systems and other evidence-based approaches to create a path that feels right for you.
(832) 345-3756 View (832) 345-3756
Photo of Rebecca Oyer, Clinical Social Work/Therapist, MSW, LCSW, SEP, ISPP
Rebecca Oyer
Clinical Social Work/Therapist, MSW, LCSW, SEP, ISPP
Online Only
I have been practicing as a psychotherapist for 30 years and I very much enjoy my work. My goal is to help people with healing, and in so doing help them to live a more joyful and meaningful life. I have years of experience helping clients address and recover from many different issues. I work with emotional wounds that are often at the core of issues that clients bring to me, and with healing trauma including religious trauma. I have found that when these wounds can be addressed in a safe environment, healing can take place. I work with adults of all life stages, with adolescents, children, with individuals, families and groups.
I have been practicing as a psychotherapist for 30 years and I very much enjoy my work. My goal is to help people with healing, and in so doing help them to live a more joyful and meaningful life. I have years of experience helping clients address and recover from many different issues. I work with emotional wounds that are often at the core of issues that clients bring to me, and with healing trauma including religious trauma. I have found that when these wounds can be addressed in a safe environment, healing can take place. I work with adults of all life stages, with adolescents, children, with individuals, families and groups.
(337) 243-6887 View (337) 243-6887
Photo of Amanda Genus, Clinical Social Work/Therapist, LCSW, MSW
Amanda Genus
Clinical Social Work/Therapist, LCSW, MSW
Online Only
Start. Restore. Heal. I would like to assist you with gaining control over your life through building positive coping strategies to help you address current psychosocial adaptations and poor coping skills. My focus will help you to reduce your mental health symptoms by developing healthy life choices, positive coping skills, and improved self image. I can assist you in building positive relationships and connections. I am currently providing Telehealth therapeutic services for individuals, couples and families, seeking therapeutic support.
Start. Restore. Heal. I would like to assist you with gaining control over your life through building positive coping strategies to help you address current psychosocial adaptations and poor coping skills. My focus will help you to reduce your mental health symptoms by developing healthy life choices, positive coping skills, and improved self image. I can assist you in building positive relationships and connections. I am currently providing Telehealth therapeutic services for individuals, couples and families, seeking therapeutic support.
(971) 247-1218 View (971) 247-1218
Photo of Jessica M Feinsmith, Licensed Professional Counselor, MA, LPC
Jessica M Feinsmith
Licensed Professional Counselor, MA, LPC
1 Endorsed
Online Only
Not accepting new clients
You feel unmotivated, disconnected, or overwhelmed—like the things that once brought comfort no longer work. You want support, but trusting someone feels hard. I offer a grounded, compassionate space to help you build self-acceptance, resilience, and direction. I specialize in working with neuro diverse young adults, caregivers, HSPs, late bloomers, and creative minds navigating identity, purpose, and emotional depth. Inner peace is where change begins. If you're a parent of a young adult who is struggling, let me help support your child during their formative experiences and increase their tools for living a life of integrity.
You feel unmotivated, disconnected, or overwhelmed—like the things that once brought comfort no longer work. You want support, but trusting someone feels hard. I offer a grounded, compassionate space to help you build self-acceptance, resilience, and direction. I specialize in working with neuro diverse young adults, caregivers, HSPs, late bloomers, and creative minds navigating identity, purpose, and emotional depth. Inner peace is where change begins. If you're a parent of a young adult who is struggling, let me help support your child during their formative experiences and increase their tools for living a life of integrity.
(517) 994-1188 View (517) 994-1188
Photo of Hannah Hall, Pre-Licensed Professional, CSWA, QMHP
Hannah Hall
Pre-Licensed Professional, CSWA, QMHP
Online Only
I believe therapy is a collaborative process of growth and exploration. Taking the step to begin therapy can be challenging, but I am here to support you wherever you are in your journey. It is important to me to make my clients feel safe, heard, and understood. I am passionate about working with adults ages 20-65 who are experiencing a variety of stressors and mental health conditions.
I believe therapy is a collaborative process of growth and exploration. Taking the step to begin therapy can be challenging, but I am here to support you wherever you are in your journey. It is important to me to make my clients feel safe, heard, and understood. I am passionate about working with adults ages 20-65 who are experiencing a variety of stressors and mental health conditions.
(971) 306-4604 x1 View (971) 306-4604 x1
Photo of Will Helfrich, Clinical Social Work/Therapist, LCSW
Will Helfrich
Clinical Social Work/Therapist, LCSW
1 Endorsed
Online Only
Welcome and congratulations on taking the step of seeking out therapy; I find that contacting someone is the most difficult part. As you look for a therapist, I encourage you to first consider characteristics of the individual you believe you’ll connect with most and consider their education, licensure, and clinical approach second.
Welcome and congratulations on taking the step of seeking out therapy; I find that contacting someone is the most difficult part. As you look for a therapist, I encourage you to first consider characteristics of the individual you believe you’ll connect with most and consider their education, licensure, and clinical approach second.
(971) 315-4730 View (971) 315-4730
Photo of Kallie Cothern, Licensed Professional Counselor, M.Ed, LPC
Kallie Cothern
Licensed Professional Counselor, M.Ed, LPC
Online Only
You’ve taken a big step toward greater wellness, happiness, and healing by beginning this search. I understand that choosing a therapist can feel overwhelming, so I am happy to answer any questions that you may have, beyond this profile. I am a licensed professional counselor and certified yoga teacher using an integrative and collaborative approach in my work with clients. I strive to provide a safe environment for exploration, healing, and transformation by fostering a supportive and non-judgmental space where clients can comfortably discuss sensitive topics, and address underlying issues to foster healing and growth.
You’ve taken a big step toward greater wellness, happiness, and healing by beginning this search. I understand that choosing a therapist can feel overwhelming, so I am happy to answer any questions that you may have, beyond this profile. I am a licensed professional counselor and certified yoga teacher using an integrative and collaborative approach in my work with clients. I strive to provide a safe environment for exploration, healing, and transformation by fostering a supportive and non-judgmental space where clients can comfortably discuss sensitive topics, and address underlying issues to foster healing and growth.
(971) 399-3159 View (971) 399-3159
Photo of Liz Ramirez, Counselor, LPC, LMHC, NCC, CADC II
Liz Ramirez
Counselor, LPC, LMHC, NCC, CADC II
1 Endorsed
Online Only
My passion has always been helping people who feel the need for change in their lives. I have extensive experience assisting clients with trauma, anxiety, depression, relationship distress, legal challenges, substance abuse & recovery issues, transition difficulties, and other life challenges. My approach is direct, yet compassionate and non-judgmental. I utilize an eclectic approach to therapy, and partner with clients to reach mutually agreed upon goals. I believe that you are an expert in your own life, and I am simply there to guide you and challenge you toward a happier, healthier version of yourself.
My passion has always been helping people who feel the need for change in their lives. I have extensive experience assisting clients with trauma, anxiety, depression, relationship distress, legal challenges, substance abuse & recovery issues, transition difficulties, and other life challenges. My approach is direct, yet compassionate and non-judgmental. I utilize an eclectic approach to therapy, and partner with clients to reach mutually agreed upon goals. I believe that you are an expert in your own life, and I am simply there to guide you and challenge you toward a happier, healthier version of yourself.
(360) 524-3530 View (360) 524-3530
Photo of Tatiana Coundoul, Marriage & Family Therapist, MS, LMFT
Tatiana Coundoul
Marriage & Family Therapist, MS, LMFT
Online Only
Together we will focus on identifying the underlying root issues. I will support you as you heal unhealthy cycles and patterns in their life, strengthen relationships and live more authentically. As a therapist I am passionate about helping people gain a deep understanding of themselves. Deep understanding and insight is an essential component of change.
Together we will focus on identifying the underlying root issues. I will support you as you heal unhealthy cycles and patterns in their life, strengthen relationships and live more authentically. As a therapist I am passionate about helping people gain a deep understanding of themselves. Deep understanding and insight is an essential component of change.
(760) 428-1443 View (760) 428-1443

Online Therapists

Photo of Alexander Deussen, Clinical Social Work/Therapist, LCSW
Alexander Deussen
Clinical Social Work/Therapist, LCSW
1 Endorsed
Portland, OR 97223
Every person has the capacity to change and heal and live authentically. I offer a supportive and nonjudgmental environment for self-exploration, growth and expansion. I have over 20 years of experience working with adults, young adults, teenagers, and families who have experienced trauma, relationship strains, anxiety and depression.
Every person has the capacity to change and heal and live authentically. I offer a supportive and nonjudgmental environment for self-exploration, growth and expansion. I have over 20 years of experience working with adults, young adults, teenagers, and families who have experienced trauma, relationship strains, anxiety and depression.
(503) 213-6453 View (503) 213-6453
Photo of Laura Eccles, Clinical Social Work/Therapist, LCSW
Laura Eccles
Clinical Social Work/Therapist, LCSW
Portland, OR 97215
You come to therapy to find out nothing is wrong with you. I believe individuals have an inherent capacity for healing, even from deep wounds. My goal is to help you break free from what Buddhist psychologist Tara Brach describes as the "trance of unworthiness" often resulting from difficult personal experiences and systemic oppression and societal structures that harm us. My aim is to empower individuals to not only address the symptoms of trauma, depression and anxiety, but also to dismantle the underlying beliefs that may have taken root as a result of being a human in an unjust society.
You come to therapy to find out nothing is wrong with you. I believe individuals have an inherent capacity for healing, even from deep wounds. My goal is to help you break free from what Buddhist psychologist Tara Brach describes as the "trance of unworthiness" often resulting from difficult personal experiences and systemic oppression and societal structures that harm us. My aim is to empower individuals to not only address the symptoms of trauma, depression and anxiety, but also to dismantle the underlying beliefs that may have taken root as a result of being a human in an unjust society.
(503) 897-9057 View (503) 897-9057
Photo of Will Mahan, Licensed Professional Counselor, MS, LPC, NCC
Will Mahan
Licensed Professional Counselor, MS, LPC, NCC
1 Endorsed
Portland, OR 97205
Many people come to therapy because life feels heavier than it should — anxiety that won’t quiet down, depression that keeps pulling you under, or career and life transitions that feel confusing or overwhelming. Some are navigating relationship patterns, perfectionism, or OCD symptoms that make it hard to feel grounded. Others simply want a space to sort things out with someone who’s warm, direct, and genuinely engaged. I work with adults dealing with anxiety, depression, OCD, career stress, burnout, and major life changes.
Many people come to therapy because life feels heavier than it should — anxiety that won’t quiet down, depression that keeps pulling you under, or career and life transitions that feel confusing or overwhelming. Some are navigating relationship patterns, perfectionism, or OCD symptoms that make it hard to feel grounded. Others simply want a space to sort things out with someone who’s warm, direct, and genuinely engaged. I work with adults dealing with anxiety, depression, OCD, career stress, burnout, and major life changes.
(404) 229-6177 View (404) 229-6177
Photo of Justin Hamacher - Justin Hamacher, Cascade Jungian Northwest, Pre-Licensed Professional, MS
Justin Hamacher, Cascade Jungian Northwest
Pre-Licensed Professional, MS
1 Endorsed
Portland, OR 97202
People arrive at Jungian analysis for a variety of reasons, a life difficulty, trauma, crossroads, challenges with human relationships, curiosity around dreams and creativity, or a hunger to learn and explore Jungian topics. Jungian work is about reclaiming one's narrative, through integration of unconscious and conscious aspects of the self. This work can help a person feel more authentic, balanced and whole (the Jungian concept of individuation) or 'living life to one's own truest state'. I support a broad range of clients and work with people across the United States and Europe, with ages ranging from the 20s to 80s.
People arrive at Jungian analysis for a variety of reasons, a life difficulty, trauma, crossroads, challenges with human relationships, curiosity around dreams and creativity, or a hunger to learn and explore Jungian topics. Jungian work is about reclaiming one's narrative, through integration of unconscious and conscious aspects of the self. This work can help a person feel more authentic, balanced and whole (the Jungian concept of individuation) or 'living life to one's own truest state'. I support a broad range of clients and work with people across the United States and Europe, with ages ranging from the 20s to 80s.
(971) 306-5168 View (971) 306-5168
Photo of Sam Wilson, Clinical Social Work/Therapist, MSW, LCSW-C
Sam Wilson
Clinical Social Work/Therapist, MSW, LCSW-C
2 Endorsed
Portland, OR 97212
Do you feel trapped by circumstances beyond your control? Are you unable to escape negative thoughts? Have you forgotten why you made the decisions that led you to this moment? Talk therapy can offer a way forward. Therapy can be a safe space to catch your breath, to talk out ideas that feel strange or risky, and to devise a new strategy for reconnecting with your best self. I'll do my best to help no matter what you're facing but right now I'm especially enthusiastic about working with young adults and professionals coping with ADHD, men's issues, relationship issues, gambling addiction, depression, anger management or anxiety.
Do you feel trapped by circumstances beyond your control? Are you unable to escape negative thoughts? Have you forgotten why you made the decisions that led you to this moment? Talk therapy can offer a way forward. Therapy can be a safe space to catch your breath, to talk out ideas that feel strange or risky, and to devise a new strategy for reconnecting with your best self. I'll do my best to help no matter what you're facing but right now I'm especially enthusiastic about working with young adults and professionals coping with ADHD, men's issues, relationship issues, gambling addiction, depression, anger management or anxiety.
(240) 292-8651 View (240) 292-8651
Photo of Amy Altenberger, Licensed Professional Counselor, MA, LPC, LMHC
Amy Altenberger
Licensed Professional Counselor, MA, LPC, LMHC
Portland, OR 97232
Grief and trauma. When experienced, these can define us. But it doesn’t have to be that way. People are also shaped by their families and culture, their experiences, and the stories they create about themselves. I too have experienced grief and trauma and through our work together, I will help you find your voice and create a new narrative – one of empowerment, acceptance, and hope. I believe in a collaborative and nurturing approach to counseling. Like life, counseling is a journey. We’re in this together.
Grief and trauma. When experienced, these can define us. But it doesn’t have to be that way. People are also shaped by their families and culture, their experiences, and the stories they create about themselves. I too have experienced grief and trauma and through our work together, I will help you find your voice and create a new narrative – one of empowerment, acceptance, and hope. I believe in a collaborative and nurturing approach to counseling. Like life, counseling is a journey. We’re in this together.
(503) 217-6082 View (503) 217-6082
Photo of Robin Kathleen Bodhi - Robin Bodhi Trauma-Informed Counseling, Counselor, MA, LMHC, LPC
Robin Bodhi Trauma-Informed Counseling
Counselor, MA, LMHC, LPC
5 Endorsed
Portland, OR 97214
Are you an empath feeling trapped in cycles of anxiety, overwhelm, or C-PTSD? You’re not alone. When triggers take over, it feels like life is controlling you instead of the other way around—disconnecting you from yourself and those around you. These patterns may leave you feeling powerless, frustrated, or even hopeless. But healing is possible. I specialize in helping people break free from these loops by guiding them toward self-empowerment, nervous system regulation, deeper self-connection, improved relationships and greater joy in life.
Are you an empath feeling trapped in cycles of anxiety, overwhelm, or C-PTSD? You’re not alone. When triggers take over, it feels like life is controlling you instead of the other way around—disconnecting you from yourself and those around you. These patterns may leave you feeling powerless, frustrated, or even hopeless. But healing is possible. I specialize in helping people break free from these loops by guiding them toward self-empowerment, nervous system regulation, deeper self-connection, improved relationships and greater joy in life.
(503) 966-9271 View (503) 966-9271
Photo of Nate Lindsay, Clinical Social Work/Therapist, LCSW
Nate Lindsay
Clinical Social Work/Therapist, LCSW
Portland, OR 97205
With my dog by my side, my primary focus is supporting boys and men with an ADHD diagnosis. I specialize in working with fathers to address their individual and family system needs. Additionally, I offer therapy to therapists. I'm here to help you move beyond “surviving” and finding an inspired path forward, feeling less alone and more whole.
With my dog by my side, my primary focus is supporting boys and men with an ADHD diagnosis. I specialize in working with fathers to address their individual and family system needs. Additionally, I offer therapy to therapists. I'm here to help you move beyond “surviving” and finding an inspired path forward, feeling less alone and more whole.
(971) 203-0782 View (971) 203-0782

How does your Therapist compare?

Number of Therapists in Piedmont, Portland, OR

10+

Average cost per session

$180

Therapists in Piedmont, Portland, OR who prioritize treating:

100% Anxiety
92% Depression
92% Stress
83% Relationship Issues
83% Grief
75% Trauma and PTSD
75% Self Esteem

Average years in practice

16 Years

Top 3 insurances accepted

75% Regence
63% Aetna
63% UnitedHealthcare UHC | UBH

How Therapists in Piedmont, Portland, OR see their clients

67% Online Only
33% In Person and Online

Gender breakdown

75% Female
25% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Piedmont, 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.