Photo of Tessa A Stephens, LCSW, Clinical Social Work/Therapist
Tessa A Stephens
Clinical Social Work/Therapist, LCSW
Verified Verified
Louisville, KY 40299
I am a Licensed Clinical Social Worker (LCSW) who has worked with people of all ages and backgrounds. I work with people suffering from the symptoms of depression, anxiety, mood disorders, PTSD, poor self-esteem, grief and loss, family and relationship issues among other things. I have years of experience in working with school-aged children to address school issues and behavioral problems, including those diagnosed with ADHD. I especially enjoy working with neurodivergent clients, although everyone is welcome in my practice!
I am a Licensed Clinical Social Worker (LCSW) who has worked with people of all ages and backgrounds. I work with people suffering from the symptoms of depression, anxiety, mood disorders, PTSD, poor self-esteem, grief and loss, family and relationship issues among other things. I have years of experience in working with school-aged children to address school issues and behavioral problems, including those diagnosed with ADHD. I especially enjoy working with neurodivergent clients, although everyone is welcome in my practice!
(502) 206-0588 View (502) 206-0588
Photo of Charlotte Yang, MS, Marriage & Family Therapist Associate
Charlotte Yang
Marriage & Family Therapist Associate, MS
Verified Verified
1 Endorsed
Louisville, KY 40299
I enjoy working with adolescents, adults, couples, and families from all walks of life. I provide support to those who are experiencing a wide range of mental health struggles and life concerns such as anxiety, depression, trauma, relationship issues, attachment issues, and those facing difficult life transitions.
I enjoy working with adolescents, adults, couples, and families from all walks of life. I provide support to those who are experiencing a wide range of mental health struggles and life concerns such as anxiety, depression, trauma, relationship issues, attachment issues, and those facing difficult life transitions.
(502) 586-4448 View (502) 586-4448
Photo of Nancy L. McDonald, MDiv, Marriage & Family Therapist
Nancy L. McDonald
Marriage & Family Therapist, MDiv
Verified Verified
1 Endorsed
Louisville, KY 40299
Not accepting new clients
Broken relationships, being "stuck" in unhealthy patterns, negative self-thoughts, and imprints from past abuse can feel overwhelming, but freedom is possible. I approach soul care with authenticity, compassion, honesty, and a non-judgmental approach, and I am passionate about helping women address emotional pain and experience God's restoration out of brokenness. It is a beautiful process to witness, and I am honored when I am trusted with an opportunity to be a part of it!
Broken relationships, being "stuck" in unhealthy patterns, negative self-thoughts, and imprints from past abuse can feel overwhelming, but freedom is possible. I approach soul care with authenticity, compassion, honesty, and a non-judgmental approach, and I am passionate about helping women address emotional pain and experience God's restoration out of brokenness. It is a beautiful process to witness, and I am honored when I am trusted with an opportunity to be a part of it!
(502) 514-4027 View (502) 514-4027
Photo of Jonathan Yussman, LPCA, LCADCA, NCC, Counselor
Jonathan Yussman
Counselor, LPCA, LCADCA, NCC
Verified Verified
Louisville, KY 40299
I strive to provide the highest possible quality mental health care services at affordable rates. I use an eclectic, strength-based approach when working with clients. I take the time to get to know clients very well, and then choose the best approach from therapies such as client-centered, cognitive behavioral, and reality therapy. I believe the relationship between the therapist and client is one of the most important elements in therapy.
I strive to provide the highest possible quality mental health care services at affordable rates. I use an eclectic, strength-based approach when working with clients. I take the time to get to know clients very well, and then choose the best approach from therapies such as client-centered, cognitive behavioral, and reality therapy. I believe the relationship between the therapist and client is one of the most important elements in therapy.
(502) 677-3601 View (502) 677-3601
Photo of Dr. Diedre L Wade - Acacia Vitality , PhD, LPCC-S, LMHC
Acacia Vitality
Licensed Professional Clinical Counselor, PhD, LPCC-S, LMHC
Verified Verified
1 Endorsed
Louisville, KY 40299  (Online Only)
Do you have goals for your life but don't know where to start? Do you want to make positive changes but need help figuring out how to improve or stick with a plan of action? I specialize in Mental Toughness, which is the concept of not only being resilient but also seeking out challenges to improve even more.
Do you have goals for your life but don't know where to start? Do you want to make positive changes but need help figuring out how to improve or stick with a plan of action? I specialize in Mental Toughness, which is the concept of not only being resilient but also seeking out challenges to improve even more.
(502) 373-8234 View (502) 373-8234
Photo of Amanda Thomason Paul - Amanda T. Paul, LCSW, CPC - Telehealth Clinician, LCSW, CPC, Clinical Social Work/Therapist
Amanda T. Paul, LCSW, CPC - Telehealth Clinician
Clinical Social Work/Therapist, LCSW, CPC
Verified Verified
Louisville, KY 40299  (Online Only)
Not accepting new clients
Have you found yourself overwhelmed by the stress and changes of everyday life? Or perhaps you find yourself facing a major transition in life and are unsure of your next steps. Maybe you are finding it difficult to find balance in your life with all of its demands and expectations. You may have even had a negative experience with therapy in the past because you didn't feel heard or understood. Perhaps you are just looking for a supportive ear and a therapist willing to co-journey with you while you determine the right path for you.
Have you found yourself overwhelmed by the stress and changes of everyday life? Or perhaps you find yourself facing a major transition in life and are unsure of your next steps. Maybe you are finding it difficult to find balance in your life with all of its demands and expectations. You may have even had a negative experience with therapy in the past because you didn't feel heard or understood. Perhaps you are just looking for a supportive ear and a therapist willing to co-journey with you while you determine the right path for you.
(502) 586-2902 View (502) 586-2902
Photo of Ann D Minch, LCSW, Clinical Social Work/Therapist
Ann D Minch
Clinical Social Work/Therapist, LCSW
Verified Verified
2 Endorsed
Louisville, KY 40299  (Online Only)
Now offering Ketamine assisted therapy & integration. Referral to local ketamine clinic, I provide the psychotherapy. With 25+ years of counseling experience I can help you create a new chapter to your life story. Do you feel "stuck", repeating patterns that get in the way of you having the life you want? Do you battle with depression, anxiety or low self-worth or are unresolved issues interfering with you achieving your goals? Do you struggle with family relationships or getting over childhood events? Are you an adult with ADHD & need help developing strategies to be successful? Do you have unresolved trauma?
Now offering Ketamine assisted therapy & integration. Referral to local ketamine clinic, I provide the psychotherapy. With 25+ years of counseling experience I can help you create a new chapter to your life story. Do you feel "stuck", repeating patterns that get in the way of you having the life you want? Do you battle with depression, anxiety or low self-worth or are unresolved issues interfering with you achieving your goals? Do you struggle with family relationships or getting over childhood events? Are you an adult with ADHD & need help developing strategies to be successful? Do you have unresolved trauma?
(502) 858-8694 View (502) 858-8694
Photo of Teressa Crawford - Aster Counseling Services LLC, EdS, LPCC-S, KY, LPC OK, Counselor
Aster Counseling Services LLC
Counselor, EdS, LPCC-S, KY, LPC OK
Verified Verified
1 Endorsed
Louisville, KY 40299  (Online Only)
As a dedicated mental health therapist, I specialize in empowering women ages 18-65 to overcome challenges and achieve their mental health goals. My expertise includes helping clients set boundaries, process childhood trauma, improve communication skills, and boost self-esteem. I provide compassionate support for managing depression, anxiety, mood disorders, life stage issues, life transitions, and grief. Women seek my guidance to reclaim their narratives, enhance their personal and professional relationships, and navigate life’s changes with resilience. Together, we can foster growth, healing, and lasting positive change.
As a dedicated mental health therapist, I specialize in empowering women ages 18-65 to overcome challenges and achieve their mental health goals. My expertise includes helping clients set boundaries, process childhood trauma, improve communication skills, and boost self-esteem. I provide compassionate support for managing depression, anxiety, mood disorders, life stage issues, life transitions, and grief. Women seek my guidance to reclaim their narratives, enhance their personal and professional relationships, and navigate life’s changes with resilience. Together, we can foster growth, healing, and lasting positive change.
(502) 804-2409 View (502) 804-2409
Photo of Anna Bunch, LPCC
Anna Bunch
Licensed Professional Clinical Counselor, LPCC
Verified Verified
1 Endorsed
Louisville, KY 40299  (Online Only)
Anna Marie Bunch, M.Ed, LPCC, LCADC, is a licensed therapist with over 11 years of experience in the field of mental health. She holds a Master's of Education in Human Services and Counseling and is licensed to practice in Kentucky and Ohio. Throughout her career, Anna Marie has worked in a variety of settings, including private practice, K-12 schools, and residential recovery programs. Her diverse background has equipped her with a deep understanding of the complexities of the human experience and a wealth of knowledge in helping individuals overcome obstacles and thrive.
Anna Marie Bunch, M.Ed, LPCC, LCADC, is a licensed therapist with over 11 years of experience in the field of mental health. She holds a Master's of Education in Human Services and Counseling and is licensed to practice in Kentucky and Ohio. Throughout her career, Anna Marie has worked in a variety of settings, including private practice, K-12 schools, and residential recovery programs. Her diverse background has equipped her with a deep understanding of the complexities of the human experience and a wealth of knowledge in helping individuals overcome obstacles and thrive.
(502) 829-8054 View (502) 829-8054
Photo of Katie Esquibel, MA, ATR, LPAT, Art Therapist
Katie Esquibel
Art Therapist, MA, ATR, LPAT
Verified Verified
2 Endorsed
Louisville, KY 40299
I am a Licensed Art Therapist who believes in the power of the therapeutic relationship to facilitate change. My therapeutic approach is integrative, using strength based, client-centered, and holistic practices. As an art therapist, clients have the option to engage in art therapy. No experience with art required. The creative process, artwork, and discussion provides an opportunity to integrate fractured pieces of the mind, body, and spirit.
I am a Licensed Art Therapist who believes in the power of the therapeutic relationship to facilitate change. My therapeutic approach is integrative, using strength based, client-centered, and holistic practices. As an art therapist, clients have the option to engage in art therapy. No experience with art required. The creative process, artwork, and discussion provides an opportunity to integrate fractured pieces of the mind, body, and spirit.
(502) 936-6546 View (502) 936-6546
Photo of Jason Sandquist, LCSW, Clinical Social Work/Therapist
Jason Sandquist
Clinical Social Work/Therapist, LCSW
Verified Verified
Louisville, KY 40299
I am a Christian therapist, though I have no difficulties working with clients of all beliefs. I am comfortable meeting with individuals and families, and I'm comfortable meeting with children and/or adults. I believe in the power of healing and restoration. I believe in hope and change. I believe life has meaning and we can find it. I believe in strong individuals, couples, and families who can learn to live life in honesty and contentment. I also know that working through life's issues/obstacles takes time and I want to help you on your journey towards wholeness and fulfillment.
I am a Christian therapist, though I have no difficulties working with clients of all beliefs. I am comfortable meeting with individuals and families, and I'm comfortable meeting with children and/or adults. I believe in the power of healing and restoration. I believe in hope and change. I believe life has meaning and we can find it. I believe in strong individuals, couples, and families who can learn to live life in honesty and contentment. I also know that working through life's issues/obstacles takes time and I want to help you on your journey towards wholeness and fulfillment.
(502) 252-1943 View (502) 252-1943
Photo of Deborah Richard, PhD, LPC
Deborah Richard
Licensed Professional Clinical Counselor, PhD, LPC
Verified Verified
Louisville, KY 40299
Finding the right therapist is extremely important. The strength of client-therapist bond privides the positive and accepting atmosphere in which issues of mind/spirit/body may be addressed. By exploring and addressing the roots of current problems, resolution and healing can be manifested in the client's life. My focus for each client is to maximize their potential. I take a conversational-collaborative and eclectic approach as I work with clients with various issues. My clients set goals and leave therapy with the skills they need. Sessions usually occur weekly in an effort to maintain a constructive intensity toward self-awareness and restoration.
Finding the right therapist is extremely important. The strength of client-therapist bond privides the positive and accepting atmosphere in which issues of mind/spirit/body may be addressed. By exploring and addressing the roots of current problems, resolution and healing can be manifested in the client's life. My focus for each client is to maximize their potential. I take a conversational-collaborative and eclectic approach as I work with clients with various issues. My clients set goals and leave therapy with the skills they need. Sessions usually occur weekly in an effort to maintain a constructive intensity toward self-awareness and restoration.
(502) 871-4121 View (502) 871-4121
Photo of Lynde Revert, LCSW, Clinical Social Work/Therapist
Lynde Revert
Clinical Social Work/Therapist, LCSW
Verified Verified
Louisville, KY 40299  (Online Only)
Hi! I’m a Licensed Clinical Social Worker in Louisville, KY, and I’ve spent the last 12 years helping people with substance use disorders. I’ve worked in outpatient therapy, inpatient behavioral health, and acute medical hospitals. My main focus is providing person-centered care to those struggling not just with substance use, but also with depression, anxiety, trauma, and the stresses of daily life.
Hi! I’m a Licensed Clinical Social Worker in Louisville, KY, and I’ve spent the last 12 years helping people with substance use disorders. I’ve worked in outpatient therapy, inpatient behavioral health, and acute medical hospitals. My main focus is providing person-centered care to those struggling not just with substance use, but also with depression, anxiety, trauma, and the stresses of daily life.
(859) 249-8566 View (859) 249-8566
Photo of Hannah Hartigan, LPCC
Hannah Hartigan
Licensed Professional Clinical Counselor, LPCC
Verified Verified
2 Endorsed
Jeffersontown, KY 40299  (Online Only)
I am a licensed clinical mental health therapist with a clinical career specializing in substance abuse, life transitions, anxiety and depression. I have now transitioned to private practice to work with individuals needing support in their daily lives. I enjoy helping adults face the challenges of work, marriage, and parenthood while also helping them navigate anxiety, depression, stress and substances. I believe in a solution-based approach and helping my patients build skills that they can bring forward into their everyday lives. I look forward to talking to you soon!
I am a licensed clinical mental health therapist with a clinical career specializing in substance abuse, life transitions, anxiety and depression. I have now transitioned to private practice to work with individuals needing support in their daily lives. I enjoy helping adults face the challenges of work, marriage, and parenthood while also helping them navigate anxiety, depression, stress and substances. I believe in a solution-based approach and helping my patients build skills that they can bring forward into their everyday lives. I look forward to talking to you soon!
(502) 427-7649 View (502) 427-7649
Photo of Rebecca L Donaldson Accepting New Clients, CSW, Clinical Social Work/Therapist
Rebecca L Donaldson Accepting New Clients
Clinical Social Work/Therapist, CSW
Verified Verified
1 Endorsed
Louisville, KY 40299
We all need help at times to manage life's challenges. I strive to provide a safe, compassionate, judgment-free space for you to navigate the healing process. I believe in a person's right to live their life as they see fit and in providing individualized treatment to best suit their personal needs and goals. I have experience working with adults, adolescents, children, and families with a diverse range of issues such as depression, anxiety, attachment disorders, mood disorders, personality disorders, adjustment disorders, ADHD, and trauma.
We all need help at times to manage life's challenges. I strive to provide a safe, compassionate, judgment-free space for you to navigate the healing process. I believe in a person's right to live their life as they see fit and in providing individualized treatment to best suit their personal needs and goals. I have experience working with adults, adolescents, children, and families with a diverse range of issues such as depression, anxiety, attachment disorders, mood disorders, personality disorders, adjustment disorders, ADHD, and trauma.
(502) 334-1233 View (502) 334-1233
John Junius Banks
Marriage & Family Therapist Associate, M, FTA
Verified Verified
1 Endorsed
Jeffersontown, KY 40299
What gives me satisfaction as a therapist is enabling individuals, couples and families to overcome their life challenges. I look forward to assisting you who are stuck in anxiety, depression and other emotional stressors. I can assist you to become empowered with problem solving skills to resolve these challenges.
What gives me satisfaction as a therapist is enabling individuals, couples and families to overcome their life challenges. I look forward to assisting you who are stuck in anxiety, depression and other emotional stressors. I can assist you to become empowered with problem solving skills to resolve these challenges.
(502) 467-6721 View (502) 467-6721
Photo of Karen Westbrooks, PhD, LMFT, LPC, Marriage & Family Therapist
Karen Westbrooks
Marriage & Family Therapist, PhD, LMFT, LPC
Verified Verified
3 Endorsed
Louisville, KY 40299  (Online Only)
Even in the 21st century, "having issues" still carries a stigma. Therapists are here to help you make your life better, but we are still not fully understood by the public. I'm guilty of not understanding dentists. I went to the dentist "only when" the pain was so bad I couldn't stand it, or "only when" I had to have a tooth yanked. Only in mid-life, after years of misery, did I understand dentists as being real doctors. Now, I respect the connection between healthy gums and healthy heart and I spare myself the prolonged anguish.
Even in the 21st century, "having issues" still carries a stigma. Therapists are here to help you make your life better, but we are still not fully understood by the public. I'm guilty of not understanding dentists. I went to the dentist "only when" the pain was so bad I couldn't stand it, or "only when" I had to have a tooth yanked. Only in mid-life, after years of misery, did I understand dentists as being real doctors. Now, I respect the connection between healthy gums and healthy heart and I spare myself the prolonged anguish.
(502) 437-3534 View (502) 437-3534
Photo of Stacy Seitz Conley, MA, LPP
Stacy Seitz Conley
MA, LPP
Verified Verified
Louisville, KY 40299
If you have been struggling with emotional difficulties, or if your family has had difficulties adjusting, I have over 20 years of experience helping adults, children, teens, and families who struggle with a variety of emotional and relational problems. In therapy I integrate CBT, ACT, mindfulness, and expressive activities with a client-centered nature infused interpersonal approach. I give regular homework and coach clients to practice skills learned and encourage family involvement to accelerate their therapeutic progress. I assess each individual's biopsychosocialspiritual needs and develop goals addressing their entire being.
If you have been struggling with emotional difficulties, or if your family has had difficulties adjusting, I have over 20 years of experience helping adults, children, teens, and families who struggle with a variety of emotional and relational problems. In therapy I integrate CBT, ACT, mindfulness, and expressive activities with a client-centered nature infused interpersonal approach. I give regular homework and coach clients to practice skills learned and encourage family involvement to accelerate their therapeutic progress. I assess each individual's biopsychosocialspiritual needs and develop goals addressing their entire being.
(502) 610-0157 View (502) 610-0157
Photo of Benjamin M Hoffman, LCSW, LMFT, Clinical Social Work/Therapist
Benjamin M Hoffman
Clinical Social Work/Therapist, LCSW, LMFT
Verified Verified
Louisville, KY 40299
Are you tired of feeling like a stranger in your own skin? Ready to reclaim your sense of belonging and control over your life? Let's embark on a journey together towards inner healing and self-discovery. Despite the pandemic of loneliness, anxiety, and depression, finding peace is possible. Whether you're grappling with past traumas, striving to boost your self-esteem, or simply seeking relief from the weight of negative emotions, I am here to guide you through every step of the process.
Are you tired of feeling like a stranger in your own skin? Ready to reclaim your sense of belonging and control over your life? Let's embark on a journey together towards inner healing and self-discovery. Despite the pandemic of loneliness, anxiety, and depression, finding peace is possible. Whether you're grappling with past traumas, striving to boost your self-esteem, or simply seeking relief from the weight of negative emotions, I am here to guide you through every step of the process.
(502) 383-0237 View (502) 383-0237
Photo of Chanel Watkins, MFTA, CSW, Marriage & Family Therapist Associate
Chanel Watkins
Marriage & Family Therapist Associate, MFTA, CSW
Verified Verified
Louisville, KY 40299  (Online Only)
In my work with clients, I prioritize an approach grounded in empowering and supporting individuals in their journey toward change, growth, and healing. I foster a collaborative, nonjudgemental environment where clients can freely explore all aspects of themselves. My practice is centered on holistic, trauma-informed care, utilizing evidence-based therapeutic modalities such as: Dialectical Behavior Therapy (DBT), Cognitive Behavioral Therapy (CBT), and Emotionally Focused Therapy (EFT) etc.
In my work with clients, I prioritize an approach grounded in empowering and supporting individuals in their journey toward change, growth, and healing. I foster a collaborative, nonjudgemental environment where clients can freely explore all aspects of themselves. My practice is centered on holistic, trauma-informed care, utilizing evidence-based therapeutic modalities such as: Dialectical Behavior Therapy (DBT), Cognitive Behavioral Therapy (CBT), and Emotionally Focused Therapy (EFT) etc.
(502) 738-1453 View (502) 738-1453
1

How does your Therapist compare?

Number of Therapists in 40299

70+

Average cost per session

$122

Therapists in 40299 who prioritize treating:

92% Anxiety
82% Depression
76% Relationship Issues
73% Trauma and PTSD
65% Coping Skills
63% Self Esteem
60% Family Conflict

Average years in practice

12 Years

Top 3 insurances accepted

78% BlueCross and BlueShield
69% Aetna
69% Elevance

How Therapists in 40299 see their clients

70% In Person and Online
30% Online Only

Gender breakdown

81% Female
19% Male
FAQs - About Therapy and Counseling

How can I find a therapist in 40299?

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.