Therapists in Oregon

View cities and counties in Oregon
Photo of Deb Blackstone, MA, DVATI
Deb Blackstone
MA, DVATI
Verified Verified
1 Endorsed
Cottage Grove, OR 97424
My approach to counseling begins with developing a relationship with clients so I can understand what has brought them to therapy. To look at situations within the larger context of our lives--past and present, family and friends, and the beliefs and attitudes that shape personal experience. Healing happens on many levels, often looking very different from one person to the next, and it can take time to build a relationship and establish enough trust to bring someone new into our life. This is something that can't be rushed.
My approach to counseling begins with developing a relationship with clients so I can understand what has brought them to therapy. To look at situations within the larger context of our lives--past and present, family and friends, and the beliefs and attitudes that shape personal experience. Healing happens on many levels, often looking very different from one person to the next, and it can take time to build a relationship and establish enough trust to bring someone new into our life. This is something that can't be rushed.
(541) 501-5397 View (541) 501-5397
Photo of Lauren Diaz, MS, NCC, Licensed Professional Counselor
Lauren Diaz
Licensed Professional Counselor, MS, NCC
Verified Verified
1 Endorsed
Medford, OR 97504  (Online Only)
Not accepting new clients
I believe that we are all trying the best we can to live our most authentic life. My mission as a therapist is to help you feel more confident in all areas of your life. During our work together, I am committed to finding the tools that can help you reach your goals on your journey towards healing. Together, we will overcome blocks that are preventing you from living the life that you want to be living and prioritize your own well-being in the way that feels most authentic for you. I specialize in working with people who are struggling with trauma, PTSD, dissociation, anxiety, and depression.
I believe that we are all trying the best we can to live our most authentic life. My mission as a therapist is to help you feel more confident in all areas of your life. During our work together, I am committed to finding the tools that can help you reach your goals on your journey towards healing. Together, we will overcome blocks that are preventing you from living the life that you want to be living and prioritize your own well-being in the way that feels most authentic for you. I specialize in working with people who are struggling with trauma, PTSD, dissociation, anxiety, and depression.
(541) 293-5377 View (541) 293-5377
Photo of Kate Gillespie, LCSW , Clinical Social Work/Therapist
Kate Gillespie
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Eugene, OR 97401
Waitlist for new clients
We are collectively experiencing a major upheaval in our world, and because of this we are at point where we can make positive social change. The pain of deep wounds caused by generations of suffering and injustice impacts our day to day lives. The systems that we live in are significantly out of date, and in turn they are harmful to our mental, physical, emotional, and spiritual health. Healing on an individual level is the first step to healing families and communities. Reaching for support can make an important difference in navigating difficult feelings, memories, and situations.
We are collectively experiencing a major upheaval in our world, and because of this we are at point where we can make positive social change. The pain of deep wounds caused by generations of suffering and injustice impacts our day to day lives. The systems that we live in are significantly out of date, and in turn they are harmful to our mental, physical, emotional, and spiritual health. Healing on an individual level is the first step to healing families and communities. Reaching for support can make an important difference in navigating difficult feelings, memories, and situations.
(458) 216-5981 View (458) 216-5981
Photo of Madalyn Twist, CSWA
Madalyn Twist
Clinical Social Work Associate, CSWA
Verified Verified
Portland, OR 97214  (Online Only)
Are you ready to begin taking off the masks that you are afraid of living without but know you cannot live within? Together, we will gently remove old and new masks, allowing for the opportunity to get to know your inner Self. The Self is our inner being, our truth, our soul, our anchor, who often gets hidden away due to traumatic experiences, fears, and others’ expectations. Through witnessing how personal challenges - past and present - can impact individuals in distinct ways, I have grown increasingly passionate about helping others reconnect with life through Self-discovery.
Are you ready to begin taking off the masks that you are afraid of living without but know you cannot live within? Together, we will gently remove old and new masks, allowing for the opportunity to get to know your inner Self. The Self is our inner being, our truth, our soul, our anchor, who often gets hidden away due to traumatic experiences, fears, and others’ expectations. Through witnessing how personal challenges - past and present - can impact individuals in distinct ways, I have grown increasingly passionate about helping others reconnect with life through Self-discovery.
(971) 265-8474 View (971) 265-8474
Photo of undefined - Yaga Healing Place, LCSW, Clinical Social Work/Therapist
Yaga Healing Place
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Salem, OR 97301
My clinical framework is rooted in attachment theory, which reiterates the delicate nature of the relationship between mother and baby. This relationship is integral to everything in our world and yet we often trivialize this relationship and assume that if there is a happy, healthy baby, then our mothers should remain perfectly aligned. The truth is, we know that the journey of motherhood is far more complex and intertwined, than how society portrays it.
My clinical framework is rooted in attachment theory, which reiterates the delicate nature of the relationship between mother and baby. This relationship is integral to everything in our world and yet we often trivialize this relationship and assume that if there is a happy, healthy baby, then our mothers should remain perfectly aligned. The truth is, we know that the journey of motherhood is far more complex and intertwined, than how society portrays it.
(971) 251-1850 View (971) 251-1850
Photo of undefined - Janiene Beauchene, Youth & Family Therapist, JD, LCSW, Clinical Social Work/Therapist
Janiene Beauchene, Youth & Family Therapist
Clinical Social Work/Therapist, JD, LCSW
Verified Verified
Beaverton, OR 97005
I assist youth and families to build and maintain strong relationships. I teach parents skills to help their children both change challenging behavior and shift to a place of deep healing and connection. I address family of origin issues with parents allowing them to cope with their past, so that they can remain responsive, engaged and calm during stressful times. I assist in working through trauma coming from child abuse, neglect, sexual assault, and violence. I assist those going through stages of grief: helping them learn how to live beyond the loss.
I assist youth and families to build and maintain strong relationships. I teach parents skills to help their children both change challenging behavior and shift to a place of deep healing and connection. I address family of origin issues with parents allowing them to cope with their past, so that they can remain responsive, engaged and calm during stressful times. I assist in working through trauma coming from child abuse, neglect, sexual assault, and violence. I assist those going through stages of grief: helping them learn how to live beyond the loss.
(503) 573-8718 View (503) 573-8718
Photo of McKenzie Maddigan, MCOUN , LPCA
McKenzie Maddigan
Professional Counselor Associate , MCOUN , LPCA
Verified Verified
3 Endorsed
Bend, OR 97702
I view therapy as an avenue to transform our pain into our teacher. My role is to provide a safe, trusting relationship for individuals to express themselves, explore their emotions, and probe their patterns and the systems in which they live.
I view therapy as an avenue to transform our pain into our teacher. My role is to provide a safe, trusting relationship for individuals to express themselves, explore their emotions, and probe their patterns and the systems in which they live.
(458) 217-1767 View (458) 217-1767
Photo of Andrew G Kenagy, PsyD, Psychologist
Andrew G Kenagy
Psychologist, PsyD
Verified Verified
Salem, OR 97302
My practice focuses on people who want to enjoy greater peace and more satisfying relationships. I’m pleased to serve children, adolescents, and adults. The emphasis of my work includes treating depression, anxiety, PTSD, interpersonal difficulties, psycho-spiritual issues, ADHD, and child/adolescent behavior problems.
My practice focuses on people who want to enjoy greater peace and more satisfying relationships. I’m pleased to serve children, adolescents, and adults. The emphasis of my work includes treating depression, anxiety, PTSD, interpersonal difficulties, psycho-spiritual issues, ADHD, and child/adolescent behavior problems.
(971) 260-3447 View (971) 260-3447
Photo of Megan Vaughn, MA, LMFT, Marriage & Family Therapist
Megan Vaughn
Marriage & Family Therapist, MA, LMFT
Verified Verified
5 Endorsed
Portland, OR 97232
Does your romantic relationship need a life line? I'll help you and your partner create lasting change in your relationship. We'll work through the rupture of disconnection, infidelity, parenting, physical intimacy and sex and get to the connection you desire. I work with individual clients on tackling the unmanageable, in their relationships with others and self. We'll explore what's kept you stuck for so long and uncover deep meaning and happiness in your relationships and in your personal story.
Does your romantic relationship need a life line? I'll help you and your partner create lasting change in your relationship. We'll work through the rupture of disconnection, infidelity, parenting, physical intimacy and sex and get to the connection you desire. I work with individual clients on tackling the unmanageable, in their relationships with others and self. We'll explore what's kept you stuck for so long and uncover deep meaning and happiness in your relationships and in your personal story.
(503) 714-7732 View (503) 714-7732
Photo of Stacia D'Anna, LPC, Licensed Professional Counselor
Stacia D'Anna
Licensed Professional Counselor, LPC
Verified Verified
Salem, OR 97301
Not accepting new clients
My experience working with children, adolescents, adults, and families have led me to a passion for specific areas of study and practice. I believe in an eclectic approach which draws on a multitude of theories and treatment interventions including DBT; EMDR; Polyvagal Theory and Somatic Regulation; solution-focused; CBT; Sand-Play and Psychodynamic theory.
My experience working with children, adolescents, adults, and families have led me to a passion for specific areas of study and practice. I believe in an eclectic approach which draws on a multitude of theories and treatment interventions including DBT; EMDR; Polyvagal Theory and Somatic Regulation; solution-focused; CBT; Sand-Play and Psychodynamic theory.
(503) 966-9650 View (503) 966-9650
Photo of Anna Hawkins, MA, MFT, Marriage & Family Therapist
Anna Hawkins
Marriage & Family Therapist, MA, MFT
Verified Verified
1 Endorsed
Portland, OR 97215
I welcome your rough edges, tender places, inner wisdom, and the search for more fulfillment. Together, we will invite self-compassion and acceptance around what is already happening, while also creating ways to experience more satisfying ways of treating yourself, being with others, and inhabiting your life. My clients include people who experience depression, anxiety, grief, anger, and shame, creative folks who are stalled at manifesting their potential, gentle souls who find it hard to navigate in a frenetic world, people who want to establish fresh relationship patterns, and those who are recovering their balance amidst life transitions.
I welcome your rough edges, tender places, inner wisdom, and the search for more fulfillment. Together, we will invite self-compassion and acceptance around what is already happening, while also creating ways to experience more satisfying ways of treating yourself, being with others, and inhabiting your life. My clients include people who experience depression, anxiety, grief, anger, and shame, creative folks who are stalled at manifesting their potential, gentle souls who find it hard to navigate in a frenetic world, people who want to establish fresh relationship patterns, and those who are recovering their balance amidst life transitions.
(503) 476-9524 View (503) 476-9524
Photo of Dr. Sarah B Silverman, PsyD, Psychologist
Dr. Sarah B Silverman
Psychologist, PsyD
Verified Verified
2 Endorsed
Eugene, OR 97401  (Online Only)
Waitlist for new clients
Individual therapy for ages 18+: A lot of my clients have sought out my services because they have felt "a little lost" in life. Whether it be work stress, parenting, or relationship issues, life became overwhelming and maybe some symptoms of anxiety and depression appeared. I work with clients by joining with them in their journey and figuring out what is happening and what next steps are truly desired. Many of my clients have been with me for years as we bump (or roller coaster) along life's journey. Therapy is NOT in-person and is conducted via Zoom. Accepting PacificSource and PacficSource OHP or self-pay.
Individual therapy for ages 18+: A lot of my clients have sought out my services because they have felt "a little lost" in life. Whether it be work stress, parenting, or relationship issues, life became overwhelming and maybe some symptoms of anxiety and depression appeared. I work with clients by joining with them in their journey and figuring out what is happening and what next steps are truly desired. Many of my clients have been with me for years as we bump (or roller coaster) along life's journey. Therapy is NOT in-person and is conducted via Zoom. Accepting PacificSource and PacficSource OHP or self-pay.
(458) 237-4405 View (458) 237-4405
Photo of Henry K Weddle, MSW, QMHP-R, CSWA, Pre-Licensed Professional
Henry K Weddle
Pre-Licensed Professional, MSW, QMHP-R, CSWA
Verified Verified
1 Endorsed
Oregon City, OR 97045
Not accepting new clients
I work to support both Teens and Young Adults in navigating the stressors of life as well as helping to create a smooth transition into adulthood. Stress and anxiety related to school, peer & family relationships, and/or tasks related to the transition from childhood to adulthood are all areas in which I can work with clients. I offer both in-person and telehealth outpatient therapy for youth and young adults ages 15-25 and accept clients both older and younger than this range on a case-by-case basis depending on level of need and the client's ability to actively engage in the therapeutic relationship.
I work to support both Teens and Young Adults in navigating the stressors of life as well as helping to create a smooth transition into adulthood. Stress and anxiety related to school, peer & family relationships, and/or tasks related to the transition from childhood to adulthood are all areas in which I can work with clients. I offer both in-person and telehealth outpatient therapy for youth and young adults ages 15-25 and accept clients both older and younger than this range on a case-by-case basis depending on level of need and the client's ability to actively engage in the therapeutic relationship.
(503) 406-4159 View (503) 406-4159
Photo of Carolyn S Hughes, PhD, LCSW, Clinical Social Work/Therapist
Carolyn S Hughes
Clinical Social Work/Therapist, PhD, LCSW
Verified Verified
Lake Oswego, OR 97034  (Online Only)
Waitlist for new clients
I enjoy working with individuals who are seeking a real change in their life. Sometimes you are "tired of the rut I am in" or feeling that "something needs to change..I do not want to feel like this anymore." Sometimes you are struggling with "old issues" and sometimes it is more current stresses like anxiety, relationships, or just do not know what to do next; I believe when you are ready to make a change, having a supportive push can really work!
I enjoy working with individuals who are seeking a real change in their life. Sometimes you are "tired of the rut I am in" or feeling that "something needs to change..I do not want to feel like this anymore." Sometimes you are struggling with "old issues" and sometimes it is more current stresses like anxiety, relationships, or just do not know what to do next; I believe when you are ready to make a change, having a supportive push can really work!
(719) 387-0439 View (719) 387-0439
Photo of Jamie Barton, MS, LPC, Licensed Professional Counselor
Jamie Barton
Licensed Professional Counselor, MS, LPC
Verified Verified
Ashland, OR 97520
Waitlist for new clients
Remembering what your last therapist told you, “diets don’t work” interrupts your cycling thoughts that you should skip a meal today. No matter how little you have eaten or how much you have exercised, you never felt thin enough to fit into those expensive designer jeans saved for when you lose a little weight. You’ve already tried everything from restricting the kinds of food you eat by cutting out carbs and sugar to going paleo. Since you grew up watching your mom diet and make negative comments about her body, it makes sense that you have imagined that eating "clean" or "healthy" would give you a sense of security.
Remembering what your last therapist told you, “diets don’t work” interrupts your cycling thoughts that you should skip a meal today. No matter how little you have eaten or how much you have exercised, you never felt thin enough to fit into those expensive designer jeans saved for when you lose a little weight. You’ve already tried everything from restricting the kinds of food you eat by cutting out carbs and sugar to going paleo. Since you grew up watching your mom diet and make negative comments about her body, it makes sense that you have imagined that eating "clean" or "healthy" would give you a sense of security.
(541) 577-4979 View (541) 577-4979
Photo of Ashley Brown, LCSW, CADCIII, Clinical Social Work/Therapist
Ashley Brown
Clinical Social Work/Therapist, LCSW, CADCIII
Verified Verified
Ashland, OR 97520  (Online Only)
I believe all of us are doing the best we can with what’s in front of us. I also believe we all deserve support, guidance, and someone to understand our dark moments, our lost moments, our hard-to-figure-out moments. That’s why I’m here. I have worked as a licensed therapist with all types of humans for over 12 years. I’m down to earth, experienced, and hard to surprise. I can both firmly challenge distorted beliefs while also bringing incredible compassion for just how hard things are sometimes. I believe in the necessity of humor and value of creative expression as a way to be heard, especially when you can’t find the right words
I believe all of us are doing the best we can with what’s in front of us. I also believe we all deserve support, guidance, and someone to understand our dark moments, our lost moments, our hard-to-figure-out moments. That’s why I’m here. I have worked as a licensed therapist with all types of humans for over 12 years. I’m down to earth, experienced, and hard to surprise. I can both firmly challenge distorted beliefs while also bringing incredible compassion for just how hard things are sometimes. I believe in the necessity of humor and value of creative expression as a way to be heard, especially when you can’t find the right words
View
Photo of Karl Reichert, LMHC, Counselor
Karl Reichert
Counselor, LMHC
Verified Verified
Portland, OR 97223  (Online Only)
Do you constantly feel like you’re slightly out of sync with most people? Maybe you frequently take things too literally. Maybe you constantly make movie reference quotes, but no one ever knows what you’re talking about. You shut down when you’re overwhelmed and you’ve been told that means you have depression—but you aren’t quite sure that’s right. One minute you’re in control of your emotions, and the next minute you’re lashing out at others. You don’t understand why you’re so overwhelmed this time, when you have previously handled situations like this with ease? Do you find yourself often anxious and avoidant of people and places?
Do you constantly feel like you’re slightly out of sync with most people? Maybe you frequently take things too literally. Maybe you constantly make movie reference quotes, but no one ever knows what you’re talking about. You shut down when you’re overwhelmed and you’ve been told that means you have depression—but you aren’t quite sure that’s right. One minute you’re in control of your emotions, and the next minute you’re lashing out at others. You don’t understand why you’re so overwhelmed this time, when you have previously handled situations like this with ease? Do you find yourself often anxious and avoidant of people and places?
(360) 448-1417 View (360) 448-1417
Photo of Robert Gitelson, LCSW, Clinical Social Work/Therapist
Robert Gitelson
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Keizer, OR 97303
Over the past 32 years, I have had the amazing opportunity to collaboratively work with clients, being supportive and providing gentle guidance as they learned to identify, clarify, and develop effective coping skills to manage and resolve the stress in their lives. Whether you are experiencing depression, anxiety, trying to cope with parenting concerns, Adult Attention Deficit Hyperactivity Disorder, marital stress/conflict, self-esteem challenges, or a variety of life struggles; I believe that my client-centered therapeutic approach will assist you in gaining greater self-awareness and emotional growth.
Over the past 32 years, I have had the amazing opportunity to collaboratively work with clients, being supportive and providing gentle guidance as they learned to identify, clarify, and develop effective coping skills to manage and resolve the stress in their lives. Whether you are experiencing depression, anxiety, trying to cope with parenting concerns, Adult Attention Deficit Hyperactivity Disorder, marital stress/conflict, self-esteem challenges, or a variety of life struggles; I believe that my client-centered therapeutic approach will assist you in gaining greater self-awareness and emotional growth.
(503) 374-1488 View (503) 374-1488
Photo of Brad Creel, Licensed Professional Counselor
Brad Creel
Licensed Professional Counselor
Verified Verified
Portland, OR 97215
Waitlist for new clients
My practice is currently full, please reach out you would like to be added to the waiting list (est. 1-2 months). I offer a compassionate, non-judgmental, therapeutic environment where my clients can feel welcome and safe. As a psychodynamic therapist, I believe that healing can happen through accessing the realm of the unconscious. This process of exploring thoughts and images can be daunting, but also immensely satisfying and life changing.
My practice is currently full, please reach out you would like to be added to the waiting list (est. 1-2 months). I offer a compassionate, non-judgmental, therapeutic environment where my clients can feel welcome and safe. As a psychodynamic therapist, I believe that healing can happen through accessing the realm of the unconscious. This process of exploring thoughts and images can be daunting, but also immensely satisfying and life changing.
(503) 303-0794 View (503) 303-0794
Photo of Kay Brown, MA
Kay Brown
Professional Counselor Associate, MA
Verified Verified
4 Endorsed
Bend, OR 97702
Waitlist for new clients
I provide mental health therapy for individuals (18+) and couples who reside in Oregon. I offer a warm, supportive therapeutic relationship where we work together to address your hopes and fears. Through individual therapy, I will work with you to explore issues in your life that are limiting your ability to experience joy or reach your goals while guiding you towards recognizing and reconnecting with your whole self. Together, we can address what is going on in your life and your relationships so that you can find more peace, connectivity, and satisfaction.
I provide mental health therapy for individuals (18+) and couples who reside in Oregon. I offer a warm, supportive therapeutic relationship where we work together to address your hopes and fears. Through individual therapy, I will work with you to explore issues in your life that are limiting your ability to experience joy or reach your goals while guiding you towards recognizing and reconnecting with your whole self. Together, we can address what is going on in your life and your relationships so that you can find more peace, connectivity, and satisfaction.
View

How does your Therapist compare?

Average cost per session

$160

Therapists in Oregon who prioritize treating:

91% Anxiety
85% Depression
76% Relationship Issues
74% Trauma and PTSD
74% Self Esteem
70% Stress
65% Grief

Average years in practice

11 Years

Top 3 insurances accepted

60% PacificSource
44% Oregon Health Plan (OHP)
43% Aetna

How Therapists in Oregon see their clients

63% In Person and Online
37% Online Only

Gender breakdown

76% Female
21% Male
3% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Oregon?

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.