Therapists in Wallowa, OR

Photo of Annie Tomlinson, Licensed Professional Counselor, MA CMHC, LPC
Annie Tomlinson
Licensed Professional Counselor, MA CMHC, LPC
2 Endorsed
Online Only
I love working with people ready to step into the next phase of their lives. It can be challenging to find your way through it all and maintain contact with your values and honoring all your parts. I enjoy working with neurodivergents, eccentrics, perfectionists, the highly sensitive, and creatives. I aim to help folks create lives full of supports, joyful purpose, deep relationships, and the confidence to get you through whatever you are facing. I also enjoy working with couples and polyamorous individuals.
I love working with people ready to step into the next phase of their lives. It can be challenging to find your way through it all and maintain contact with your values and honoring all your parts. I enjoy working with neurodivergents, eccentrics, perfectionists, the highly sensitive, and creatives. I aim to help folks create lives full of supports, joyful purpose, deep relationships, and the confidence to get you through whatever you are facing. I also enjoy working with couples and polyamorous individuals.
(541) 576-1431 View (541) 576-1431

More Therapists Nearby

Photo of Colleen McDonald, Clinical Social Work/Therapist, LCSW
Colleen McDonald
Clinical Social Work/Therapist, LCSW
Online Only
Beginning therapy can seem overwhelming. I congratulate you on starting your journey, and I'm here to make sure it is meaningful to you. I have extensive experience working with individuals with anxiety and depression. I take a client-centered, collaborative approach to therapy, focusing each therapy session on your unique needs. I use cognitive-behavioral therapy (CBT) and Acceptance and Commitment Therapy (ACT) to help you reshape unhelpful thought patterns. This approach is hands-on and gives you tools to feel more control over your emotions and behaviors.
Beginning therapy can seem overwhelming. I congratulate you on starting your journey, and I'm here to make sure it is meaningful to you. I have extensive experience working with individuals with anxiety and depression. I take a client-centered, collaborative approach to therapy, focusing each therapy session on your unique needs. I use cognitive-behavioral therapy (CBT) and Acceptance and Commitment Therapy (ACT) to help you reshape unhelpful thought patterns. This approach is hands-on and gives you tools to feel more control over your emotions and behaviors.
(971) 257-5609 View (971) 257-5609
Photo of Carrise Murray, Clinical Social Work Associate
Carrise Murray
Clinical Social Work Associate
Online Only
As a mental health therapist, I provide compassionate and evidence-based support to individuals navigating challenges such as anxiety, ADHD, depression, grief, and life transitions. I create a safe, nonjudgmental space where clients can explore their emotions, understand their experiences, and develop healthier ways of thinking and coping. My approach is tailored to meet each client’s unique needs, drawing from modalities such as cognitive-behavioral therapy (CBT), dialectical behavioral therapy (DBT), and Acceptance Commitment Therapy (ACT) as well as mindfulness practices, and solution-focused techniques.
As a mental health therapist, I provide compassionate and evidence-based support to individuals navigating challenges such as anxiety, ADHD, depression, grief, and life transitions. I create a safe, nonjudgmental space where clients can explore their emotions, understand their experiences, and develop healthier ways of thinking and coping. My approach is tailored to meet each client’s unique needs, drawing from modalities such as cognitive-behavioral therapy (CBT), dialectical behavioral therapy (DBT), and Acceptance Commitment Therapy (ACT) as well as mindfulness practices, and solution-focused techniques.
(541) 391-5382 View (541) 391-5382
Photo of Suzanne B Schoenfeld, Clinical Social Work/Therapist, LCSW
Suzanne B Schoenfeld
Clinical Social Work/Therapist, LCSW
1 Endorsed
Serves Area
You’ve reached a point where you’re tired of trudging through depression or anxiety, feeling at a total loss in your relationship, or simply just not feeling like enough. You’re ready for a new normal.
You’ve reached a point where you’re tired of trudging through depression or anxiety, feeling at a total loss in your relationship, or simply just not feeling like enough. You’re ready for a new normal.
(503) 994-1348 View (503) 994-1348
Photo of McKayla Forsberg, Clinical Social Work/Therapist, LCSW
McKayla Forsberg
Clinical Social Work/Therapist, LCSW
Online Only
Hi there! I am so glad you are here. I am an independently licensed clinical social worker and am actively accepting new clients in Washington. I have experience working in schools, primary care and community health. I specialize in children and families, trauma, anxiety, depression, life changes, relationship issues, and neurodivergence. I believe in building a collaborative relationship with my clients an I create a safe space for people to feel comfortable sharing their emotions. I would love to work with you!
Hi there! I am so glad you are here. I am an independently licensed clinical social worker and am actively accepting new clients in Washington. I have experience working in schools, primary care and community health. I specialize in children and families, trauma, anxiety, depression, life changes, relationship issues, and neurodivergence. I believe in building a collaborative relationship with my clients an I create a safe space for people to feel comfortable sharing their emotions. I would love to work with you!
(509) 517-7628 View (509) 517-7628
Photo of Anna Lembke, Licensed Professional Counselor, LPC
Anna Lembke
Licensed Professional Counselor, LPC
Online Only
I’m a Licensed Professional Counselor providing online therapy for adults throughout Oregon navigating anxiety, stress, trauma, life transitions, and exploring or deepening purpose, spirituality, or identity. My approach integrates trauma-informed therapy, EMDR, body-based approaches, mindfulness, self-compassion, and nervous system education. I work well with people ready to understand themselves, shift long-standing patterns, strengthen resilience, and move forward with greater intention and lasting change. My practice is also a good fit for professionals, athletes, and those navigating performance demands, burnout, and overwhelm.
I’m a Licensed Professional Counselor providing online therapy for adults throughout Oregon navigating anxiety, stress, trauma, life transitions, and exploring or deepening purpose, spirituality, or identity. My approach integrates trauma-informed therapy, EMDR, body-based approaches, mindfulness, self-compassion, and nervous system education. I work well with people ready to understand themselves, shift long-standing patterns, strengthen resilience, and move forward with greater intention and lasting change. My practice is also a good fit for professionals, athletes, and those navigating performance demands, burnout, and overwhelm.
(541) 694-8645 View (541) 694-8645
Photo of David Mejia, Clinical Social Work/Therapist, LCSW
David Mejia
Clinical Social Work/Therapist, LCSW
Online Only
I specialize in working with families, and individuals who have experienced or are experiencing trauma and abuse. I also see individuals who are suffering from, PTSD, anxiety, depression, or suicidal thoughts.
I specialize in working with families, and individuals who have experienced or are experiencing trauma and abuse. I also see individuals who are suffering from, PTSD, anxiety, depression, or suicidal thoughts.
(281) 957-1860 View (281) 957-1860
Photo of Alicia Zahn, Pre-Licensed Professional
Alicia Zahn
Pre-Licensed Professional
1 Endorsed
Cove, OR 97824
As a counselor with a holistic somatic relational approach, my ideal clients seek deep self-connection and often face stress, anxiety, depression, or relationship issues. They prefer a healing approach that integrates mind, body, and spirit, opting for alternatives to traditional talk therapy. Attracted to our integrative methods, including somatic practices and mindfulness, they aim to manage emotions and improve relationships. I offer a safe space for exploring their inner worlds, empowering them to heal and transform for deeper connections and fulfilling lives.
As a counselor with a holistic somatic relational approach, my ideal clients seek deep self-connection and often face stress, anxiety, depression, or relationship issues. They prefer a healing approach that integrates mind, body, and spirit, opting for alternatives to traditional talk therapy. Attracted to our integrative methods, including somatic practices and mindfulness, they aim to manage emotions and improve relationships. I offer a safe space for exploring their inner worlds, empowering them to heal and transform for deeper connections and fulfilling lives.
(541) 982-3885 View (541) 982-3885
Photo of Taylor B Miller - Thoughtful Life Counseling LLC, Licensed Professional Counselor, DVM, LPC
Thoughtful Life Counseling LLC
Licensed Professional Counselor, DVM, LPC
Online Only
Veterinarians, physicians, therapists, social service employees, and parents are indispensable as caretakers. However, personal needs, self-care, and personal boundaries are often dismissed by caretakers as indulgences. Caretakers often feel pressured to perform at unachievable levels, making it difficult for them to appreciate their own value. Worse, the relentless imbalance of caring for others without replenishing themselves may lead to personal or professional burnout. Compassion fatigue, vicarious trauma, moral distress, feelings of isolation, and difficulties in important relationships may also be present. This must change.
Veterinarians, physicians, therapists, social service employees, and parents are indispensable as caretakers. However, personal needs, self-care, and personal boundaries are often dismissed by caretakers as indulgences. Caretakers often feel pressured to perform at unachievable levels, making it difficult for them to appreciate their own value. Worse, the relentless imbalance of caring for others without replenishing themselves may lead to personal or professional burnout. Compassion fatigue, vicarious trauma, moral distress, feelings of isolation, and difficulties in important relationships may also be present. This must change.
(458) 219-7702 View (458) 219-7702

Online Therapists

Photo of Luke Matteucci, Licensed Professional Counselor, MS, MA, LPC, NCC, MAC
Luke Matteucci
Licensed Professional Counselor, MS, MA, LPC, NCC, MAC
1 Endorsed
La Grande, OR 97850
Waitlist for new clients
Sometimes getting assistance is the difference between lasting change, or staying stuck in an increasingly devastating cycle. Depression, anxiety, trauma, addiction, stress and conflict are just a few things that can be overwhelming and make life and relationships difficult to manage. Most people find themselves in this position at some point in their lives, and having the right person to navigate you through is invaluable. Luke will evaluate your situation and customize a treatment plan addressing your unique needs and goals. We specialize in treating individuals and couples.
Sometimes getting assistance is the difference between lasting change, or staying stuck in an increasingly devastating cycle. Depression, anxiety, trauma, addiction, stress and conflict are just a few things that can be overwhelming and make life and relationships difficult to manage. Most people find themselves in this position at some point in their lives, and having the right person to navigate you through is invaluable. Luke will evaluate your situation and customize a treatment plan addressing your unique needs and goals. We specialize in treating individuals and couples.
(971) 216-3848 View (971) 216-3848
Photo of Missi Brown, Clinical Social Work/Therapist
Missi Brown
Clinical Social Work/Therapist
La Grande, OR 97850
I am a licensed mental health therapist. As a young adult, I realized I kept re-creating the exact cycle I was trying to break. I saw a therapist who helped me "do the work" to create the quality of life I desired. Through lived experience, education and expertise, I am here to guide you to live the healthiest version of yourself and obtain the quality of life you desire. ​
I am a licensed mental health therapist. As a young adult, I realized I kept re-creating the exact cycle I was trying to break. I saw a therapist who helped me "do the work" to create the quality of life I desired. Through lived experience, education and expertise, I am here to guide you to live the healthiest version of yourself and obtain the quality of life you desire. ​
(541) 275-5038 View (541) 275-5038
Photo of Brian Kubesh, Clinical Social Work/Therapist, LCSW
Brian Kubesh
Clinical Social Work/Therapist, LCSW
Pendleton, OR 97801
I am a therapist with over 15 years of experience in diverse mental health settings, working with individuals facing complex trauma, severe mental illness, life transitions, and co-occurring challenges. These diverse experiences have shaped a grounded, nonjudgmental approach that meets clients where they are while supporting meaningful, lasting change. I believe therapy works best when it is collaborative, authentic, and tailored to each person’s unique strengths and goals. My aim is to create a safe, supportive space where clients feel heard, empowered, and capable of moving forward with greater clarity and resilience.
I am a therapist with over 15 years of experience in diverse mental health settings, working with individuals facing complex trauma, severe mental illness, life transitions, and co-occurring challenges. These diverse experiences have shaped a grounded, nonjudgmental approach that meets clients where they are while supporting meaningful, lasting change. I believe therapy works best when it is collaborative, authentic, and tailored to each person’s unique strengths and goals. My aim is to create a safe, supportive space where clients feel heard, empowered, and capable of moving forward with greater clarity and resilience.
(541) 204-4470 View (541) 204-4470
Photo of Kate Gekeler, Professional Counselor Associate, LPCA
Kate Gekeler
Professional Counselor Associate, LPCA
Online Only
Many of my clients come seeking relief from feeling stuck, overwhelmed, or weighed down by self-doubt, anxiety, or past experiences. They want a safe space to be truly heard and understood, guidance to recognize patterns in their thoughts and feelings, and practical tools to navigate life’s challenges. Together, we work toward goals like building self-confidence, cultivating self-compassion, improving relationships, and gaining clarity about what matters most to them. Ultimately, they want to feel more at peace, empowered to make choices aligned with their values, and live a life that feels meaningful and fulfilling.
Many of my clients come seeking relief from feeling stuck, overwhelmed, or weighed down by self-doubt, anxiety, or past experiences. They want a safe space to be truly heard and understood, guidance to recognize patterns in their thoughts and feelings, and practical tools to navigate life’s challenges. Together, we work toward goals like building self-confidence, cultivating self-compassion, improving relationships, and gaining clarity about what matters most to them. Ultimately, they want to feel more at peace, empowered to make choices aligned with their values, and live a life that feels meaningful and fulfilling.
(541) 725-6357 View (541) 725-6357
Photo of Jo Vierria Pedro-Frye, Licensed Professional Counselor, MS, QMHP-R, CADC 1
Jo Vierria Pedro-Frye
Licensed Professional Counselor, MS, QMHP-R, CADC 1
2 Endorsed
La Grande, OR 97850
You encounter stressors throughout life and the ability to cope with these stressors will wax and wane over time. If you have reached a point in your life that you find yourself struggling I would love to walk alongside you to overcome these life stressors and create better coping skills to reach a better quality of life. I specialize in treating various forms of trauma and behavior change. If you have the desire to improve your life and willing to invest in yourself I would love to work with you on reaching your goals.
You encounter stressors throughout life and the ability to cope with these stressors will wax and wane over time. If you have reached a point in your life that you find yourself struggling I would love to walk alongside you to overcome these life stressors and create better coping skills to reach a better quality of life. I specialize in treating various forms of trauma and behavior change. If you have the desire to improve your life and willing to invest in yourself I would love to work with you on reaching your goals.
(971) 791-2449 View (971) 791-2449
Photo of Drew Miller - Drew Miller LPC, Licensed Professional Counselor, MA, LPC
Drew Miller LPC
Licensed Professional Counselor, MA, LPC
2 Endorsed
Online Only
Waitlist for new clients
I’m here to help you find freedom, peace and ease within the changes of your life. To help you understand the processes of your mind and how to use the wisdom of experiencing that understanding to heal. I have been working in the field of counseling since 2000 having received my Masters of Arts (MA) in Counseling Psychology from Lewis and Clark College. I am a Licensed Professional Counselor (LPC) in Oregon and Alaska and a Licensed Mental Health Counselor (LMHC) in Washington. I offer online individual and couples counseling to adults and adolescents in Alaska, Washington, and Oregon.
I’m here to help you find freedom, peace and ease within the changes of your life. To help you understand the processes of your mind and how to use the wisdom of experiencing that understanding to heal. I have been working in the field of counseling since 2000 having received my Masters of Arts (MA) in Counseling Psychology from Lewis and Clark College. I am a Licensed Professional Counselor (LPC) in Oregon and Alaska and a Licensed Mental Health Counselor (LMHC) in Washington. I offer online individual and couples counseling to adults and adolescents in Alaska, Washington, and Oregon.
(541) 631-3629 View (541) 631-3629
Photo of Lisa Lynn Whipple, Drug & Alcohol Counselor, CADC-3, QMHP-R, CRM
Lisa Lynn Whipple
Drug & Alcohol Counselor, CADC-3, QMHP-R, CRM
1 Endorsed
Online Only
Many life experiences can leave people feeling uprooted or disconnected from who they are. In therapy, my goal is to create a space where you can slow down, feel safe, and begin to understand your story in a new way. I believe healing happens through connection, honesty, and practical support. Together we work to build insight, strengthen coping skills, and reconnect you with your resilience. Growth doesn’t mean erasing the past—it means learning how to stand firmly in your roots while continuing to rise.
Many life experiences can leave people feeling uprooted or disconnected from who they are. In therapy, my goal is to create a space where you can slow down, feel safe, and begin to understand your story in a new way. I believe healing happens through connection, honesty, and practical support. Together we work to build insight, strengthen coping skills, and reconnect you with your resilience. Growth doesn’t mean erasing the past—it means learning how to stand firmly in your roots while continuing to rise.
(541) 395-4313 View (541) 395-4313
Photo of Jeannie Mood Campbell, Marriage & Family Therapist, LMFT, MDiv
Jeannie Mood Campbell
Marriage & Family Therapist, LMFT, MDiv
2 Endorsed
La Grande, OR 97850
Waitlist for new clients
I love working with couples, individuals and families and employ a strong attachment-based approach while also specializing in trauma-reduction therapies like Accelerated Resolution Therapy (ART) and EMDR to help address old wounds that fester into current relationships. Communication skill building with couples might be one of my most favorite things to do! That, and watching clients walk out feeling lighter, divesting themselves of their trauma stories. I also love to work within a Christian framework if so desired by the client and/or family.
I love working with couples, individuals and families and employ a strong attachment-based approach while also specializing in trauma-reduction therapies like Accelerated Resolution Therapy (ART) and EMDR to help address old wounds that fester into current relationships. Communication skill building with couples might be one of my most favorite things to do! That, and watching clients walk out feeling lighter, divesting themselves of their trauma stories. I also love to work within a Christian framework if so desired by the client and/or family.
(458) 200-3786 View (458) 200-3786
Photo of Morgan Gray Lyons, Clinical Social Work/Therapist, LCSW
Morgan Gray Lyons
Clinical Social Work/Therapist, LCSW
La Grande, OR 97850
Waitlist for new clients
We all deserve lives full of joy, opportunity and love. Too often though, we find ourselves in places or periods where joy, opportunity, and love feel scarce or even absent, sometimes in ways or for reasons that are outside of our control. By working from a stance of curiosity, compassion, and non-judgment, my hope is to partner with you in building the skills and tools to navigate whatever life throws at you. Through our work together, I will aim to support you in fostering the vulnerability to love yourself and others, the strength to approach pain, and the flexibility to touch meaning and passion even on your hardest days.
We all deserve lives full of joy, opportunity and love. Too often though, we find ourselves in places or periods where joy, opportunity, and love feel scarce or even absent, sometimes in ways or for reasons that are outside of our control. By working from a stance of curiosity, compassion, and non-judgment, my hope is to partner with you in building the skills and tools to navigate whatever life throws at you. Through our work together, I will aim to support you in fostering the vulnerability to love yourself and others, the strength to approach pain, and the flexibility to touch meaning and passion even on your hardest days.
(971) 320-7650 View (971) 320-7650
Photo of Jacob Drummond, Counselor, MA, LMHCA, PCA
Jacob Drummond
Counselor, MA, LMHCA, PCA
5 Endorsed
Hermiston, OR 97838
I work with individuals experiencing trauma, depression, and anxiety. I also work with couples who are having relational conflict. Perhaps you’ve tried to manage these feelings on your own, but they keep impacting your life, relationships, and peace of mind. Whether you’re an adult, teen, or part of a couple, I’m here to support you on the path to healing. I am also a Marine Corps veteran and deeply passionate about working with veterans and first responders.
I work with individuals experiencing trauma, depression, and anxiety. I also work with couples who are having relational conflict. Perhaps you’ve tried to manage these feelings on your own, but they keep impacting your life, relationships, and peace of mind. Whether you’re an adult, teen, or part of a couple, I’m here to support you on the path to healing. I am also a Marine Corps veteran and deeply passionate about working with veterans and first responders.
(360) 585-4810 View (360) 585-4810
Photo of Lupita Kirklin, Marriage & Family Therapist, PhD, LMFT, MS
Lupita Kirklin
Marriage & Family Therapist, PhD, LMFT, MS
1 Endorsed
Online Only
With 28+ years of experience as a seasoned therapist, I provide a "sauna for your feelings," a safe space and container for you to step away from your life to reflect, release and re-align. My goal is to facilitate the identification of difficult thoughts, feelings, and past experiences that prevent us from being comfortable with who we would like to be, what we want, and the kind of relationships that we want to have with others. I find that people who fully invest in themselves have the greatest rate of success.
With 28+ years of experience as a seasoned therapist, I provide a "sauna for your feelings," a safe space and container for you to step away from your life to reflect, release and re-align. My goal is to facilitate the identification of difficult thoughts, feelings, and past experiences that prevent us from being comfortable with who we would like to be, what we want, and the kind of relationships that we want to have with others. I find that people who fully invest in themselves have the greatest rate of success.
(805) 296-7403 View (805) 296-7403

See more therapy options for Wallowa

How does your Therapist compare?

Number of Therapists in Wallowa, OR

< 10

Therapists in Wallowa, OR who prioritize treating:

100% Relationship Issues
100% ADHD
100% Depression
100% Parenting
100% Trauma and PTSD
100% Women's Issues
100% Life Transitions

Average years in practice

6 Years

Top 3 insurances accepted

100% Aetna
100% BlueCross and BlueShield
100% Cigna and Evernorth

How Therapists in Wallowa, OR see their clients

100% Online Only

Gender breakdown

100% Female
FAQs - About Therapy and Counseling

How can I find a therapist in Wallowa?

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.