Therapists in New York, NY
Alison N Kliegman
Counselor, MSEd, LMHC, CASAC
Verified Verified
New York, NY 10065 (Online Only)
Please sign up on Headway or Octave to meet with me for therapy sessions. Click on website on the side. It takes courage to seek for a more fulfilling and happier life and to take the first steps towards a change. If you are ready to take that step I am here to support and empower you. I work with clients with a wide range of concerns including depression, anxiety, LGBT issues, addictions, life issues, women’s issues. I also helped many people from a range of socio-economic backgrounds.
Please sign up on Headway or Octave to meet with me for therapy sessions. Click on website on the side. It takes courage to seek for a more fulfilling and happier life and to take the first steps towards a change. If you are ready to take that step I am here to support and empower you. I work with clients with a wide range of concerns including depression, anxiety, LGBT issues, addictions, life issues, women’s issues. I also helped many people from a range of socio-economic backgrounds.
David Young
Counselor, MA, LMHC
Verified Verified
1 Endorsed
New York, NY 10011
My approach to psychotherapy is to help my patients discover the meaning behind many of their current thoughts, feelings, and behaviors and how those experiences affect their daily lives. Psychotherapy offers a chance to explore your inner life, as well as the relationships and events that have affected you, so you can find new ways to make meaning in your life, deepens your self-awareness, free yourself from fixed patterns of relating, and experience emotional growth and lasting positive change that can lead to more authentic and fulfilling life..
My approach to psychotherapy is to help my patients discover the meaning behind many of their current thoughts, feelings, and behaviors and how those experiences affect their daily lives. Psychotherapy offers a chance to explore your inner life, as well as the relationships and events that have affected you, so you can find new ways to make meaning in your life, deepens your self-awareness, free yourself from fixed patterns of relating, and experience emotional growth and lasting positive change that can lead to more authentic and fulfilling life..
Amy Socolow
Clinical Social Work/Therapist, LCSW
Verified Verified
New York, NY 10010
In my 25 years of experience, I’ve developed a unique and highly effective method that produces clear and noticeable changes within 1-3 sessions. You will know right away if my approach is working for you, because you’ll start to feel better, calmer, happier. I use techniques from a variety of sources including (but not limited to) energy psychology, gestalt therapy, and mindfulness meditation.
In my 25 years of experience, I’ve developed a unique and highly effective method that produces clear and noticeable changes within 1-3 sessions. You will know right away if my approach is working for you, because you’ll start to feel better, calmer, happier. I use techniques from a variety of sources including (but not limited to) energy psychology, gestalt therapy, and mindfulness meditation.
Samuel Parton
Licensed Master Social Worker, LMSW
Verified Verified
New York, NY 10022
Working in schools and foster care settings for years, Sam is an expert in child and adolescent therapy. He utilizes two of the leading therapies, Cognitive Behavior Therapy (CBT) and Dialectical Behavioral Therapy (DBT). With CBT, Sam helps clients change unhelpful thought processes and behavioral patterns and aids clients in bravely facing their fears. While with DBT, he helps clients learn better emotion regulation, distress tolerance, and interpersonal skills. He is passionate about building connections and assists clients in finding strengths and skills within themselves to work through any struggles they might be experiencing.
Working in schools and foster care settings for years, Sam is an expert in child and adolescent therapy. He utilizes two of the leading therapies, Cognitive Behavior Therapy (CBT) and Dialectical Behavioral Therapy (DBT). With CBT, Sam helps clients change unhelpful thought processes and behavioral patterns and aids clients in bravely facing their fears. While with DBT, he helps clients learn better emotion regulation, distress tolerance, and interpersonal skills. He is passionate about building connections and assists clients in finding strengths and skills within themselves to work through any struggles they might be experiencing.
Yelena Ivanova
Clinical Social Work/Therapist, LCSW
Verified Verified
New York, NY 10001
In my practice, I strive to maintain a safe and creative space where you can identify and build upon strengths. I am an empathetic and knowledgeable psychotherapist, who has been practicing for over 15 years. I work with individuals and families from diverse cultural backgrounds to help them achieve greater satisfaction and fulfillment in relationships and work. Throughout my career I have worked successfully with men and women who experiences issues related to depression, anxiety, PTSD, difficult relationships and immigration conflict. My training and clinical experience will allow us to work together to understand and address your concerns and distress.
In my practice, I strive to maintain a safe and creative space where you can identify and build upon strengths. I am an empathetic and knowledgeable psychotherapist, who has been practicing for over 15 years. I work with individuals and families from diverse cultural backgrounds to help them achieve greater satisfaction and fulfillment in relationships and work. Throughout my career I have worked successfully with men and women who experiences issues related to depression, anxiety, PTSD, difficult relationships and immigration conflict. My training and clinical experience will allow us to work together to understand and address your concerns and distress.
Gaitrie Samaroo
Counselor, LMHC
Verified Verified
New York, NY 10018 (Online Only)
Gaitrie Samaroo is a licensed mental health counselor. Gaitrie’s passion for helping others help themselves guides her practice. She knows how past conflicts, present concerns, trauma, relationship challenges, and thoughts can stand in the way of living a well-rounded life. Through therapy, Gaitrie helps her patients identify and process those experiences, emotions, and challenges. She loves facilitating her patients’ unique healing processes, whatever they may look like. Gaitrie combines cognitive behavioral therapy, dialectical behavioral therapy, person-centered therapy, and practical coping skills to help her patients.
Gaitrie Samaroo is a licensed mental health counselor. Gaitrie’s passion for helping others help themselves guides her practice. She knows how past conflicts, present concerns, trauma, relationship challenges, and thoughts can stand in the way of living a well-rounded life. Through therapy, Gaitrie helps her patients identify and process those experiences, emotions, and challenges. She loves facilitating her patients’ unique healing processes, whatever they may look like. Gaitrie combines cognitive behavioral therapy, dialectical behavioral therapy, person-centered therapy, and practical coping skills to help her patients.
Michael Libonati
Clinical Social Work/Therapist, LMSW
Verified Verified
1 Endorsed
New York, NY 10128 (Online Only)
I want to offer a space where every part of you feels warmly invited to participate in the process of healing and self-understanding. Whether you are seeking help for anxiety, depression, existential dread, addiction, relationship struggles, low self-esteem, professional hurdles, or creative blocks, I believe a key ingredient to long-term change is the chance to be experienced fully without the familiar fear of judgment. This means I welcome, with compassion and gentle curiosity, the aspects of you that feel buried, objectionable, or even unacceptable, perhaps due to social stigma or fear of being rejected.
I want to offer a space where every part of you feels warmly invited to participate in the process of healing and self-understanding. Whether you are seeking help for anxiety, depression, existential dread, addiction, relationship struggles, low self-esteem, professional hurdles, or creative blocks, I believe a key ingredient to long-term change is the chance to be experienced fully without the familiar fear of judgment. This means I welcome, with compassion and gentle curiosity, the aspects of you that feel buried, objectionable, or even unacceptable, perhaps due to social stigma or fear of being rejected.
Tina Hsu
MSEd
Verified Verified
1 Endorsed
New York, NY 10003
Hello and welcome to my practice. Many stressors in the modern world may make you feel overwhelmed and struggle to cope. Perhaps you are feeling unfulfilled in one or more areas. You may be struggling with depression, anxiety, coping through substance use, or other mental health struggles that are impacting your quality of life. Seeking psychotherapy is not an easy step and requires the courage to choose to be vulnerable in entrusting your honest thoughts and feelings to a stranger. My goal is to provide a safe and supportive environment to explore issues that are important to you.
Hello and welcome to my practice. Many stressors in the modern world may make you feel overwhelmed and struggle to cope. Perhaps you are feeling unfulfilled in one or more areas. You may be struggling with depression, anxiety, coping through substance use, or other mental health struggles that are impacting your quality of life. Seeking psychotherapy is not an easy step and requires the courage to choose to be vulnerable in entrusting your honest thoughts and feelings to a stranger. My goal is to provide a safe and supportive environment to explore issues that are important to you.
Emdr Therapist Katie Simon
Clinical Social Work/Therapist, MA, LCAT, RDT
Verified Verified
New York, NY 10040
Deciding to take the first step towards growth & healing can be intimidating, and it takes courage & bravery to begin this process. Congratulations on being here & looking for opportunities for your personal growth. I believe that everyone deserves to have a space of safety & support where they can explore their strengths, vulnerabilities, & life experiences free of judgment or criticism. I love my work; I approach it in the spirit of service, & I know everyone's personal energy & life purpose are distinctly and unquestionably unique. I know for certain that you can survive making the life-changes needed to live your best life.
Deciding to take the first step towards growth & healing can be intimidating, and it takes courage & bravery to begin this process. Congratulations on being here & looking for opportunities for your personal growth. I believe that everyone deserves to have a space of safety & support where they can explore their strengths, vulnerabilities, & life experiences free of judgment or criticism. I love my work; I approach it in the spirit of service, & I know everyone's personal energy & life purpose are distinctly and unquestionably unique. I know for certain that you can survive making the life-changes needed to live your best life.
Jessica Gulmi
Clinical Social Work/Therapist, LCSW, MA
Verified Verified
New York, NY 10001
Choosing a therapist for yourself or your family in NYC can be a daunting task. I specialize in work with children, teens, and adults and am here to help you with this process as all individuals can benefit from talking with someone who is honest, direct, and compassionate.
Choosing a therapist for yourself or your family in NYC can be a daunting task. I specialize in work with children, teens, and adults and am here to help you with this process as all individuals can benefit from talking with someone who is honest, direct, and compassionate.
Kate Thacher
Psychologist, PsyD
Verified Verified
5 Endorsed
New York, NY 10001
It takes courage to ask for help when you are no longer able to manage problems or cope with distress on your own. In this moment you are taking an important step toward resolving these issues. Finding a therapist who is a good fit for you is crucial. I approach treatment primarily using Cognitive Behavioral Therapy (CBT). However, because humans are beautifully complex and uniquely individual, I understand the importance of tailoring treatment to meet your specific needs, often incorporating techniques from other evidence-based treatments. For additional information regarding my background go to: www.UnionSquarePractice.com/about-us
It takes courage to ask for help when you are no longer able to manage problems or cope with distress on your own. In this moment you are taking an important step toward resolving these issues. Finding a therapist who is a good fit for you is crucial. I approach treatment primarily using Cognitive Behavioral Therapy (CBT). However, because humans are beautifully complex and uniquely individual, I understand the importance of tailoring treatment to meet your specific needs, often incorporating techniques from other evidence-based treatments. For additional information regarding my background go to: www.UnionSquarePractice.com/about-us
15 Second Videos
Soribel Martinez
Tiffany Callaghan
Joan Lavender
Sam Fitzgerald
Riah Cohen
Rosalie Baldwin Amy
Dr. Karen Tantillo
Isabel Balazs
Tatiana Blechman
Loren C Soeiro
Vera V. Daniels
Bianca VonBank Binge Eating Recovery And Anxiety Treatment
Jeffrey Kleinberg
Maya Rose Kruger
Laura Sonneborn-Turetsky
Rachel Moses
Trishonna Salomon
Brooke English
Nathaniel Torto
Renee Welde
Amy Vigliotti, Founding Head of SelfWorks
Ania Siwek Schwartzman
Mahroo Moshari
Peter A Douglas
Michael Langlois
Steve Akchayan
Whitley Louvier
Olga Victor
Harrison Tract
Liz Yarock
Benedict Heblich
Laura Oliver
Scott Ostrowski
Grace Reeves, MA, MHC-LP at Dr Fallon's Practice
Bérengère Howard, MHC-LP at Dr Fallon's Practice
Danielle Russo
Daniel Olavarría
Mariano Casanova
Kristina Damiano
Jamie Downie
Jeanette Minson
Melissa Silver
Moshe Ratson
Gregory Gentile
Nayera Elsayed
Allison Soss
Rita Aliperti
Lakeasha Elle Sullivan
Karen Ann Davis Phd
NY Ctr Somatic Psychotherapy & Trauma Resolution
Lisbeth Parra
Mental Health Counselor, LMHC
Verified Verified
New York, NY 10018 (Online Only)
Lisbeth Parra is a licensed mental health counselor. She provides compassionate, patient-centered care for people struggling with mental health issues. She understands that patients are dealing with the stressors of everyday life, uncovering childhood trauma and its effects on their current reality, and feeling the anxiety that impacts their daily reality. Her goal is to instill a sense of strength in every patient so they can see that they have the power to live the life that they deserve. During sessions, patients can expect a supportive and empathetic environment where they can talk about their difficulties without judgement.
Lisbeth Parra is a licensed mental health counselor. She provides compassionate, patient-centered care for people struggling with mental health issues. She understands that patients are dealing with the stressors of everyday life, uncovering childhood trauma and its effects on their current reality, and feeling the anxiety that impacts their daily reality. Her goal is to instill a sense of strength in every patient so they can see that they have the power to live the life that they deserve. During sessions, patients can expect a supportive and empathetic environment where they can talk about their difficulties without judgement.
Jess J Schpero
Clinical Social Work/Therapist, LCSW
Verified Verified
New York, NY 10065 (Online Only)
Not accepting new clients
Engaging in the therapeutic process can be an incredibly rewarding act of self care. Sometimes we may feel overwhelmed with life’s challenges or be struggling to understand our reactions and emotions. It’s easy to get caught up in the chaos of life’s daily challenges, and not take the time to step back and try to ease the worry. By allowing yourself the time, you can begin to renew a sense of empowerment while also reducing feelings of distress.
Engaging in the therapeutic process can be an incredibly rewarding act of self care. Sometimes we may feel overwhelmed with life’s challenges or be struggling to understand our reactions and emotions. It’s easy to get caught up in the chaos of life’s daily challenges, and not take the time to step back and try to ease the worry. By allowing yourself the time, you can begin to renew a sense of empowerment while also reducing feelings of distress.
Karen Rothman
Psychologist, PhD
Verified Verified
New York, NY 10003
I specialize in treating adults with anxiety, OCD, panic, phobias, and trauma as well as couples facing difficulties in their relationships. My approach to treatment is rooted in Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Exposure and Response Prevention (ERP), and Integrative Behavioral Couples Therapy (IBCT)—all of which use behavioral, emotion-focused, and cognitive methods. I work in a private group psychology practice in downtown Manhattan and am available to see clients in-person and virtually.
I specialize in treating adults with anxiety, OCD, panic, phobias, and trauma as well as couples facing difficulties in their relationships. My approach to treatment is rooted in Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Exposure and Response Prevention (ERP), and Integrative Behavioral Couples Therapy (IBCT)—all of which use behavioral, emotion-focused, and cognitive methods. I work in a private group psychology practice in downtown Manhattan and am available to see clients in-person and virtually.
Mikayla Singleton
MA, MHC-LP
Verified Verified
New York, NY 10016 (Online Only)
I utilize a strength-based approach to connect and help you overcome challenges such as anxiety, depression, substance use, work-related stressors, relationships, cultural-related stressors, and trauma. In sessions, my priority is to adhere to your needs, develop a therapeutic alliance to collaborate, and encourage growth to create positive change. I have also worked with adolescents navigating educational and career transitions. I have been associated with Fairleigh Dickinson University, New York University and Center for Alternative Sentencing and Employment Services.
I utilize a strength-based approach to connect and help you overcome challenges such as anxiety, depression, substance use, work-related stressors, relationships, cultural-related stressors, and trauma. In sessions, my priority is to adhere to your needs, develop a therapeutic alliance to collaborate, and encourage growth to create positive change. I have also worked with adolescents navigating educational and career transitions. I have been associated with Fairleigh Dickinson University, New York University and Center for Alternative Sentencing and Employment Services.
Jennifer L Nelson
Counselor, PhD, LMHC
Verified Verified
New York, NY 10023 (Online Only)
I know that going to therapy can feel scary. Talking to someone about your struggles is a vulnerable place to be so it’s important to choose a therapist who you can trust and connect with. I place value on building a therapeutic relationship that is supportive, trusting, compassionate, and nonjudgmental. My aim is help people cultivate more authentic and gratifying lives. While I am best known as an eating disorder specialist, I have extensive experience in treating anxiety, depression, body image, low self-worth, and interpersonal relational difficulties.
I know that going to therapy can feel scary. Talking to someone about your struggles is a vulnerable place to be so it’s important to choose a therapist who you can trust and connect with. I place value on building a therapeutic relationship that is supportive, trusting, compassionate, and nonjudgmental. My aim is help people cultivate more authentic and gratifying lives. While I am best known as an eating disorder specialist, I have extensive experience in treating anxiety, depression, body image, low self-worth, and interpersonal relational difficulties.
Elizabeth Cobb
Clinical Social Work/Therapist, LCSW, ACT
Verified Verified
New York, NY 10123
What is holding you back? I work with young adults who don't know the answer to that question, who are struggling with life transitions, finding a purpose, and may be having a life "crisis." Often my clients are dealing with depression and anxiety related to difficulty making decisions, are stuck in an unsatisfying job, or are feeling confused and uncertain about the next step in their life. My goal is to help you understand what you want and what's holding you back.
What is holding you back? I work with young adults who don't know the answer to that question, who are struggling with life transitions, finding a purpose, and may be having a life "crisis." Often my clients are dealing with depression and anxiety related to difficulty making decisions, are stuck in an unsatisfying job, or are feeling confused and uncertain about the next step in their life. My goal is to help you understand what you want and what's holding you back.
Michael Starr
Clinical Social Work/Therapist, LCSW
Verified Verified
New York, NY 10013 (Online Only)
Seeking therapy for your child can be extremely stressful. I believe that when a child faces difficult times, it's crucial that they're supported and taught skills in order to help benefit their future. Managing the stressors of life and the behaviors our thoughts create can be extremely difficult.
Seeking therapy for your child can be extremely stressful. I believe that when a child faces difficult times, it's crucial that they're supported and taught skills in order to help benefit their future. Managing the stressors of life and the behaviors our thoughts create can be extremely difficult.
Mary J Sant'eufemia
Clinical Social Work/Therapist, LCSW
Verified Verified
New York, NY 10024 (Online Only)
If you are seeking therapy for the very first time you may be wary, not know what to look for in a therapist or how therapy works and what to expect from it. I can reassure and educate you about the process and our relationship. If you previously have been in therapy and are experiencing a re-occurring issue, a new development in your life or may be in crisis, you may also worry about connecting with your new therapist and having to start anew. I can offer a supportive, encouraging and exploratory process to help either of you feel comfortable enough to work on yourself and achieve your goals.
If you are seeking therapy for the very first time you may be wary, not know what to look for in a therapist or how therapy works and what to expect from it. I can reassure and educate you about the process and our relationship. If you previously have been in therapy and are experiencing a re-occurring issue, a new development in your life or may be in crisis, you may also worry about connecting with your new therapist and having to start anew. I can offer a supportive, encouraging and exploratory process to help either of you feel comfortable enough to work on yourself and achieve your goals.
Monique Cleminson
Psychologist, PsyD
Verified Verified
2 Endorsed
New York, NY 10002
Change is possible! My strength lies in helping you to grow personally and find emotional relief by providing support, insight, and opportunities for change within the context of a collaborative and warm therapeutic environment. My approach is genuine, encouraging, energetic, and insightful. I specialize in helping individuals gain resolution and clarity about distressing situations and emotions, uncover and develop personal strengths, generate healing of past and present wounds, and develop more personal freedom overall.
Change is possible! My strength lies in helping you to grow personally and find emotional relief by providing support, insight, and opportunities for change within the context of a collaborative and warm therapeutic environment. My approach is genuine, encouraging, energetic, and insightful. I specialize in helping individuals gain resolution and clarity about distressing situations and emotions, uncover and develop personal strengths, generate healing of past and present wounds, and develop more personal freedom overall.
See more therapy options for New York
How does your Therapist compare?
Number of Therapists in New York, NY
3,000+
Average cost per session
$200
Therapists in New York, NY who prioritize treating:
94% | Anxiety |
89% | Depression |
85% | Relationship Issues |
78% | Self Esteem |
67% | Trauma and PTSD |
66% | Stress |
63% | Coping Skills |
Average years in practice
12 Years
Top 3 insurances accepted
79% | Aetna |
62% | UnitedHealthcare UHC | UBH |
60% | Cigna and Evernorth |
How Therapists in New York, NY see their clients
59% | In Person and Online | |
41% | Online Only |
Gender breakdown
78% | Female | |
21% | Male | |
1% | Non-Binary |
FAQs - About Therapy and Counseling
How can I find a therapist in New York?
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
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.
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.
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.