Therapists in Millersville, PA

Photo of Kelly Dennis, MS, LPC, NCC, Licensed Professional Counselor
Kelly Dennis
Licensed Professional Counselor, MS, LPC, NCC
Verified Verified
6 Endorsed
Millersville, PA 17551
You deserve to live a life that leaves you excited to wake up every morning! However, if you're caught in the grip of anxiety, depression, disordered eating, negative body image, or your mind is swirling with unhelpful thoughts, waking up eager to start your day can be a struggle. Do you find it challenging to manage your emotions? Caught in a battle with food or your body and want to feel more peace and calm in your life? Are these things getting in the way of your relationships? If you answered yes to any of these, counseling may be the answer!
You deserve to live a life that leaves you excited to wake up every morning! However, if you're caught in the grip of anxiety, depression, disordered eating, negative body image, or your mind is swirling with unhelpful thoughts, waking up eager to start your day can be a struggle. Do you find it challenging to manage your emotions? Caught in a battle with food or your body and want to feel more peace and calm in your life? Are these things getting in the way of your relationships? If you answered yes to any of these, counseling may be the answer!
(717) 417-4167 View (717) 417-4167
Photo of Shelby Wallick, MSW, LCSW, Clinical Social Work/Therapist
Shelby Wallick
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Millersville, PA 17551
As a therapist, I aim to create a safe and warm environment that allows each individual to deepen self-understanding and achieve their goals in therapy. I view the therapeutic relationship as a collaboration between therapist and client to work toward change.
As a therapist, I aim to create a safe and warm environment that allows each individual to deepen self-understanding and achieve their goals in therapy. I view the therapeutic relationship as a collaboration between therapist and client to work toward change.
(717) 905-0966 View (717) 905-0966
Photo of Sarah Regner, MA, LPC, Licensed Professional Counselor
Sarah Regner
Licensed Professional Counselor, MA, LPC
Verified Verified
1 Endorsed
Millersville, PA 17551
EMAIL is best to contact: Do you experiencing ongoing anxiety and uncontrollable panic or you feeling depressed and unsure how you will get through another day. Do you desire a healthier marriage and to finally feel at peace with your life. Do you desire a closer relationship with your children and bring healing to your family. You may have tried therapy before but are desiring a different approach; a healthier alternative to health, relationships, marriage, family and life. You are finally ready to have lasting healing and restoration.
EMAIL is best to contact: Do you experiencing ongoing anxiety and uncontrollable panic or you feeling depressed and unsure how you will get through another day. Do you desire a healthier marriage and to finally feel at peace with your life. Do you desire a closer relationship with your children and bring healing to your family. You may have tried therapy before but are desiring a different approach; a healthier alternative to health, relationships, marriage, family and life. You are finally ready to have lasting healing and restoration.
(717) 584-8598 View (717) 584-8598
Photo of Laura Alleva, LCSW, Clinical Social Work/Therapist
Laura Alleva
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Millersville, PA 17551
Hi there! Whether you’re dealing with everyday school or work stress, navigating a major life change or challenging relationship dynamic, processing the death of a loved one, coping with feelings of loneliness, hopelessness, or anxiety, readjusting to a post-pandemic world, or anything in between - you’ve come to the right place and I’m so glad you’re here. I am a License Clinical Social Worker (LCSW) and have been practicing in the field for 6 years. I specialize in adolescents ages 12+ and adults.
Hi there! Whether you’re dealing with everyday school or work stress, navigating a major life change or challenging relationship dynamic, processing the death of a loved one, coping with feelings of loneliness, hopelessness, or anxiety, readjusting to a post-pandemic world, or anything in between - you’ve come to the right place and I’m so glad you’re here. I am a License Clinical Social Worker (LCSW) and have been practicing in the field for 6 years. I specialize in adolescents ages 12+ and adults.
(717) 535-8093 View (717) 535-8093
Photo of Stephanie Bridgehouse, LPC, NCC, PP-AAPT, Licensed Professional Counselor
Stephanie Bridgehouse
Licensed Professional Counselor, LPC, NCC, PP-AAPT
Verified Verified
Millersville, PA 17551
There are times when problems may seem overwhelming. Whether they're your child's problems or your own problems you may need help to manage. If you are or your child is struggling with relationships, family changes, anxiety, sadness, school difficulties, ADHD, or in any other way, let me try to help. Learning how to cope and problem solve are vital skills that I can help you or your child develop.
There are times when problems may seem overwhelming. Whether they're your child's problems or your own problems you may need help to manage. If you are or your child is struggling with relationships, family changes, anxiety, sadness, school difficulties, ADHD, or in any other way, let me try to help. Learning how to cope and problem solve are vital skills that I can help you or your child develop.
(717) 584-9462 View (717) 584-9462
Photo of Kristina Dugas, LCSW, Clinical Social Work/Therapist
Kristina Dugas
Clinical Social Work/Therapist, LCSW
Verified Verified
Millersville, PA 17551
I'm focused on creating a safe and supportive environment for clients to explore their experiences and emotions. I strive to make therapy a positive experience and have experience working with individuals aged 5 up to 25, from working with the family as a unit with small children and supporting young adults with the transitions that come with growing into adult life.
I'm focused on creating a safe and supportive environment for clients to explore their experiences and emotions. I strive to make therapy a positive experience and have experience working with individuals aged 5 up to 25, from working with the family as a unit with small children and supporting young adults with the transitions that come with growing into adult life.
(717) 899-8792 View (717) 899-8792
Photo of Nancy A Smith, PhD, LPC, I, Licensed Professional Counselor
Nancy A Smith
Licensed Professional Counselor, PhD, LPC, I
Verified Verified
Millersville, PA 17551
I have been a practicing therapist for over 30 years, so I have dealt with all kinds of problems and issues that people come in, seeking help with. My approach is eclectic and personalized and is based upon the issues you bring, your life situation, and your goals for therapy. I accept most major insurances but if you do not have insurance, or an insurance plan I do not participate in, I have a sliding fee scale and we can make something work for you. Please note: I do not accept ANY Medicare, Medicaid or Capital Blue insurance.
I have been a practicing therapist for over 30 years, so I have dealt with all kinds of problems and issues that people come in, seeking help with. My approach is eclectic and personalized and is based upon the issues you bring, your life situation, and your goals for therapy. I accept most major insurances but if you do not have insurance, or an insurance plan I do not participate in, I have a sliding fee scale and we can make something work for you. Please note: I do not accept ANY Medicare, Medicaid or Capital Blue insurance.
(412) 203-4846 View (412) 203-4846
Photo of Jill Corvino, NCC, LPC, Licensed Professional Counselor
Jill Corvino
Licensed Professional Counselor, NCC, LPC
Verified Verified
2 Endorsed
Millersville, PA 17551  (Online Only)
Do you feel overwhelmed, stressed out and tired before your day even starts. You wonder how other people juggle home, work, school, family and still look like they have it all together. We often encounter many challenges, transitions, and unexpected circumstances. Sometimes we handle these bumps with ease and others we experience overwhelming sadness, pain, loss, and anger. How would it feel if you could manage your to-do list and enjoy your life where you feel empowered and confident as a woman, as a student, as a mother, as a friend?
Do you feel overwhelmed, stressed out and tired before your day even starts. You wonder how other people juggle home, work, school, family and still look like they have it all together. We often encounter many challenges, transitions, and unexpected circumstances. Sometimes we handle these bumps with ease and others we experience overwhelming sadness, pain, loss, and anger. How would it feel if you could manage your to-do list and enjoy your life where you feel empowered and confident as a woman, as a student, as a mother, as a friend?
(717) 537-1640 View (717) 537-1640
Photo of Dr. Claudia E. Smith, PhD, Counselor
Dr. Claudia E. Smith
Counselor, PhD
Verified Verified
1 Endorsed
Millersville, PA 17551  (Online Only)
Do you have questions/concerns related to sexuality- sexual pleasure, satisfaction, desire, or are you experiencing a sexual dysfunction. These are all sensitive and intimate topics and definitely not easy to talk about without possibly feeling some shame or embarrassment. Have these concerns been impacting the quality of your relationship ? Are you feeling stuck with no clue how to move forward? Embark on a journey of discovery and transformation with me. I will guide you towards sexual empowerment and well-being. Together we will break down the barriers, embrace the power of your sexuality, and celebrate your growth!
Do you have questions/concerns related to sexuality- sexual pleasure, satisfaction, desire, or are you experiencing a sexual dysfunction. These are all sensitive and intimate topics and definitely not easy to talk about without possibly feeling some shame or embarrassment. Have these concerns been impacting the quality of your relationship ? Are you feeling stuck with no clue how to move forward? Embark on a journey of discovery and transformation with me. I will guide you towards sexual empowerment and well-being. Together we will break down the barriers, embrace the power of your sexuality, and celebrate your growth!
(570) 263-5667 View (570) 263-5667
Photo of Marsha Charles - Change Your Mind: Center for Brain-Body Wellness, MS, CSP, NCC, LPC, Licensed Professional Counselor
Change Your Mind: Center for Brain-Body Wellness
Licensed Professional Counselor, MS, CSP, NCC, LPC
Verified Verified
1 Endorsed
Millersville, PA 17551
If you are looking to feel good again, to calm your mind and body from anxiety, to improve your sleep, and process unresolved trauma.....you are looking to Change Your Mind. Prolonged stress, anxiety, PTSD, and pain have a profound impact on your health. Cognitive functions like focus, concentration, and memory can be affected. Certain physiological functions like blood pressure, melatonin production, and the GI system are compromised. Physical symptoms may include tension in the muscles, tightness of the jaw, interrupted sleep, and fatigue to name just a few.
If you are looking to feel good again, to calm your mind and body from anxiety, to improve your sleep, and process unresolved trauma.....you are looking to Change Your Mind. Prolonged stress, anxiety, PTSD, and pain have a profound impact on your health. Cognitive functions like focus, concentration, and memory can be affected. Certain physiological functions like blood pressure, melatonin production, and the GI system are compromised. Physical symptoms may include tension in the muscles, tightness of the jaw, interrupted sleep, and fatigue to name just a few.
(717) 220-0553 View (717) 220-0553
Photo of Lisa M. Speck-Casadei della Chiesa - Balanced Life Counseling, LPC, LCSW, LMFT, LMT, NCHC, Licensed Professional Counselor
Balanced Life Counseling
Licensed Professional Counselor, LPC, LCSW, LMFT, LMT, NCHC
Verified Verified
1 Endorsed
Millersville, PA 17551
It is our belief that we all have the capacity to change, heal and recover from all the things that life can throw at us. At Balanced Life Counseling, we strive to create a warm, welcoming, and trusting environment which allows us to work together towards your goals. Are you feeling overwhelmed by the pressures and stress of life? Has communication been difficult lately? Are you looking for support to navigate challenging situations or circumstances? Sometimes, it's about something more than change. It's about growth and we are passionate about joining with our clients in a safe and collaborative space to help empower their growth.
It is our belief that we all have the capacity to change, heal and recover from all the things that life can throw at us. At Balanced Life Counseling, we strive to create a warm, welcoming, and trusting environment which allows us to work together towards your goals. Are you feeling overwhelmed by the pressures and stress of life? Has communication been difficult lately? Are you looking for support to navigate challenging situations or circumstances? Sometimes, it's about something more than change. It's about growth and we are passionate about joining with our clients in a safe and collaborative space to help empower their growth.
(717) 539-4178 View (717) 539-4178
Photo of Jennifer J Jackson, LPC, CCMHC, Licensed Professional Counselor
Jennifer J Jackson
Licensed Professional Counselor, LPC, CCMHC
Verified Verified
Millersville, PA 17551
Providing in-person and Telehealth convenience to those in DE, PA and surrounding states, I am committed to help you live fully and explore your potential. I specialize in understanding and solving the life problems of the individual adult (18 and up) which may cause depression and anxiety. I have developed a deep understanding of the pressures inherent in relationships, estrangement, academia, and cultural dynamics that can fuel these conditions. I am interested in helping to identify and solve issues which cause emotional challenges. An additional interest and specialty is in helping people work through grief and loss.
Providing in-person and Telehealth convenience to those in DE, PA and surrounding states, I am committed to help you live fully and explore your potential. I specialize in understanding and solving the life problems of the individual adult (18 and up) which may cause depression and anxiety. I have developed a deep understanding of the pressures inherent in relationships, estrangement, academia, and cultural dynamics that can fuel these conditions. I am interested in helping to identify and solve issues which cause emotional challenges. An additional interest and specialty is in helping people work through grief and loss.
(302) 319-0518 View (302) 319-0518
Photo of Jennifer Fay, LPC, Licensed Professional Counselor
Jennifer Fay
Licensed Professional Counselor, LPC
Verified Verified
Millersville, PA 17551  (Online Only)
If you feel overwhelmed, anxious or stressed by all that is demanded of you by work, family, school, relationships or even yourself I’d like to join you in rediscovering peace and contentment. With a collaborative approach, we will seek to establish a sense of stability, focus and balance by cultivating harmony between the things you do and the things that you want.
If you feel overwhelmed, anxious or stressed by all that is demanded of you by work, family, school, relationships or even yourself I’d like to join you in rediscovering peace and contentment. With a collaborative approach, we will seek to establish a sense of stability, focus and balance by cultivating harmony between the things you do and the things that you want.
(223) 201-7661 View (223) 201-7661
Photo of Stefanie Scarborough, MEd, LPC, Counselor
Stefanie Scarborough
Counselor, MEd, LPC
Verified Verified
Millersville, PA 17551
Accepting New Clients. Hello! I am a licensed counselor with over 20 years of experience, in a variety of settings, in the counseling profession. I pride myself on quickly building client rapport to be able to get therapeutic work started right away. My approaches emphasis client centered, solution focused counseling with cognitive behavior therapy techniques. I have experience working with children, adolescents, young adults and couples ranging in age from 15 to 50 years old. I have worked with families and specialize in working with individuals with anxiety, depression, grief & loss, career uncertainty, and relationship issues.
Accepting New Clients. Hello! I am a licensed counselor with over 20 years of experience, in a variety of settings, in the counseling profession. I pride myself on quickly building client rapport to be able to get therapeutic work started right away. My approaches emphasis client centered, solution focused counseling with cognitive behavior therapy techniques. I have experience working with children, adolescents, young adults and couples ranging in age from 15 to 50 years old. I have worked with families and specialize in working with individuals with anxiety, depression, grief & loss, career uncertainty, and relationship issues.
(717) 282-9235 View (717) 282-9235
Photo of Bethany Graham, LPC, Licensed Professional Counselor
Bethany Graham
Licensed Professional Counselor, LPC
Verified Verified
2 Endorsed
Millersville, PA 17551  (Online Only)
Healing is a process, but not one that needs to be done alone. We all encounter challenges, problems and stress that can impact us and often leave us wounded. Emotionally wounded that is. Anxiety can feel crushing and crippling. Depression can feel dark and lonely. Relationship problems can feel confusing and hopeless. Keeping up with the demands of life can be challenging with all the burdens that weigh us down or consume our hearts and minds.
Healing is a process, but not one that needs to be done alone. We all encounter challenges, problems and stress that can impact us and often leave us wounded. Emotionally wounded that is. Anxiety can feel crushing and crippling. Depression can feel dark and lonely. Relationship problems can feel confusing and hopeless. Keeping up with the demands of life can be challenging with all the burdens that weigh us down or consume our hearts and minds.
(215) 867-6485 View (215) 867-6485
Photo of Rachel Gerrity, Pre-Licensed Professional
Rachel Gerrity
Pre-Licensed Professional
Verified Verified
1 Endorsed
Millersville, PA 17551
Therapy allows you to explore your life and discover who you are in the setting of a safe and caring relationship. In our work together, I will accept and honor you precisely as you are, recognizing your strengths and engaging in the difficult times of your life with empathy and hope. My goal is to provide a safe and supportive environment in which you may find yourself and go forward with courage and confidence. I work with individuals who are seeking help with anxiety, life transitions, eating disorders, body image difficulties, gender/sexuality affirmation, trauma, and LGBTQIA+ populations.
Therapy allows you to explore your life and discover who you are in the setting of a safe and caring relationship. In our work together, I will accept and honor you precisely as you are, recognizing your strengths and engaging in the difficult times of your life with empathy and hope. My goal is to provide a safe and supportive environment in which you may find yourself and go forward with courage and confidence. I work with individuals who are seeking help with anxiety, life transitions, eating disorders, body image difficulties, gender/sexuality affirmation, trauma, and LGBTQIA+ populations.
(717) 931-6361 View (717) 931-6361
Photo of Jeff Johnson, MS, LMFT, Marriage & Family Therapist
Jeff Johnson
Marriage & Family Therapist, MS, LMFT
Verified Verified
1 Endorsed
Millersville, PA 17551  (Online Only)
If you are looking to transform yourself or your relationship and have healthier forms of communication, more intimate and emotional forms of connection and ,overall, improve your sense of self and relationships let your journey begin. With over 20 years of mental health experience and 14 years practicing therapy, I have learned to specialize in relationship/couples therapy and work as well as individuals struggling with anxiety, depression, and other life and circumstantial issues. If you are looking to repair, strengthen, regain connection, improve intimacy, or generally work on your relationships or your mental health I can help.
If you are looking to transform yourself or your relationship and have healthier forms of communication, more intimate and emotional forms of connection and ,overall, improve your sense of self and relationships let your journey begin. With over 20 years of mental health experience and 14 years practicing therapy, I have learned to specialize in relationship/couples therapy and work as well as individuals struggling with anxiety, depression, and other life and circumstantial issues. If you are looking to repair, strengthen, regain connection, improve intimacy, or generally work on your relationships or your mental health I can help.
(223) 218-2455 View (223) 218-2455
Photo of Sue Tushingham, MS
Sue Tushingham
MS
Verified Verified
Millersville, PA 17551
Over my 30 years of experience, I have seen that when clients reach out for therapy, it is a sign of strength and a willingness to change. I view counseling as a partnership between the client and myself, and help each client learn a new skill set that enables them to grow through life's challenges. I provide a non-judgmental and calming environment, with a focus on mindfulness. A holistic approach is used, which recognizes the importance of addressing body, mind, emotions, and spirit in order to achieve and maintain health. I am a safe, neutral sounding board for clients, which allows them to learn, grow, and heal.
Over my 30 years of experience, I have seen that when clients reach out for therapy, it is a sign of strength and a willingness to change. I view counseling as a partnership between the client and myself, and help each client learn a new skill set that enables them to grow through life's challenges. I provide a non-judgmental and calming environment, with a focus on mindfulness. A holistic approach is used, which recognizes the importance of addressing body, mind, emotions, and spirit in order to achieve and maintain health. I am a safe, neutral sounding board for clients, which allows them to learn, grow, and heal.
(717) 366-7918 View (717) 366-7918
Photo of Hayley Bitner, MS, LPC, CAADC, Licensed Professional Counselor
Hayley Bitner
Licensed Professional Counselor, MS, LPC, CAADC
Verified Verified
2 Endorsed
Millersville, PA 17551  (Online Only)
Not accepting new clients
Hi, I'm Hayley! I work with clients who may experience anxiety, depression, difficulty coping with intense emotions, substance use, life transitions, low self-esteem, and relational stressors. My goal is to provide a space that encourages healing and growth in addition to moving my clients closer to their goals.
Hi, I'm Hayley! I work with clients who may experience anxiety, depression, difficulty coping with intense emotions, substance use, life transitions, low self-esteem, and relational stressors. My goal is to provide a space that encourages healing and growth in addition to moving my clients closer to their goals.
(717) 802-8138 View (717) 802-8138
Photo of Charlene Eshleman - Behavioral Healthcare Corporation, MD, PsyD, MEd, LPC, LCSW
Behavioral Healthcare Corporation
MD, PsyD, MEd, LPC, LCSW
Verified Verified
Millersville, PA 17551
Our mission: Mental health for all we serve. Our passion: Helping you achieve mental health. Life can be hard. We all have challenges. We all experience loss, stress, grief and, at some point, all of us feel overwhelmed. The team at Behavioral Healthcare Corporation has been helping people just like you deal with life's issues and restore their mental health since 2002.
Our mission: Mental health for all we serve. Our passion: Helping you achieve mental health. Life can be hard. We all have challenges. We all experience loss, stress, grief and, at some point, all of us feel overwhelmed. The team at Behavioral Healthcare Corporation has been helping people just like you deal with life's issues and restore their mental health since 2002.
(717) 502-4771 View (717) 502-4771

See more therapy options for Millersville

How does your Therapist compare?

Number of Therapists in Millersville, PA

20+

Average cost per session

$125

Therapists in Millersville, PA who prioritize treating:

85% Relationship Issues
85% Anxiety
80% Depression
75% Women's Issues
70% Life Transitions
65% Trauma and PTSD
65% Coping Skills

Average years in practice

11 Years

Top 3 insurances accepted

93% Highmark
73% Aetna
60% BlueCross and BlueShield

How Therapists in Millersville, PA see their clients

70% In Person and Online
30% Online Only

Gender breakdown

89% Female
6% Male
5% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Millersville?

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.