Therapists in Summerville, SC

Photo of Lori Gant, Licensed Professional Counselor, MA, LPC
Lori Gant
Licensed Professional Counselor, MA, LPC
3 Endorsed
Summerville, SC 29483
If you would like to live a happier, healthier life and be in control of your own world, I can help. Helping others with working on solutions to their problems is my goal. The skills that I help others learn so they can live the best life possible are the very skills that are incorporated into my own life and are ones I use on a daily basis. Time spent in session is for learning. Time in between sessions is for practicing skills. We are physically located across from Oscars Restaurant in Summerville. If you would like to schedule an intake appointment, you can use our therapy portal: https://www.therapyportal.com/p/HealingRoots/
If you would like to live a happier, healthier life and be in control of your own world, I can help. Helping others with working on solutions to their problems is my goal. The skills that I help others learn so they can live the best life possible are the very skills that are incorporated into my own life and are ones I use on a daily basis. Time spent in session is for learning. Time in between sessions is for practicing skills. We are physically located across from Oscars Restaurant in Summerville. If you would like to schedule an intake appointment, you can use our therapy portal: https://www.therapyportal.com/p/HealingRoots/
(854) 888-9572 View (854) 888-9572
Photo of Caitlin Beyer, Licensed Professional Counselor, MA, MS, LPCA
Caitlin Beyer
Licensed Professional Counselor, MA, MS, LPCA
2 Endorsed
Summerville, SC 29486
Hi there! I'm really happy that you're here, because I know how hard it can be just to take this first step. Life can feel heavy sometimes — maybe you're feeling anxious, depressed, stuck, overwhelmed, or just not like yourself lately. Maybe you're working through a tough relationship, past trauma, or difficult emotions that feel hard to untangle. You're looking for a space where you can talk freely, feel supported, and begin to heal. My clients often come in wanting clarity, calm, skills to help them cope, and a deeper connection to themselves and others — and they’re ready to take that first step.
Hi there! I'm really happy that you're here, because I know how hard it can be just to take this first step. Life can feel heavy sometimes — maybe you're feeling anxious, depressed, stuck, overwhelmed, or just not like yourself lately. Maybe you're working through a tough relationship, past trauma, or difficult emotions that feel hard to untangle. You're looking for a space where you can talk freely, feel supported, and begin to heal. My clients often come in wanting clarity, calm, skills to help them cope, and a deeper connection to themselves and others — and they’re ready to take that first step.
(843) 305-6751 View (843) 305-6751
Photo of Kathryn R Hood, Licensed Professional Counselor, LPC, EdS, BC-TMH, MEd, RPT
Kathryn R Hood
Licensed Professional Counselor, LPC, EdS, BC-TMH, MEd, RPT
Summerville, SC 29485
I specialize in treating women going through challenging life transitions. Are you having difficulty in your marriage or relationship? Are you separated or going through a divorce & feeling sad & lost? Do you need support navigating work or school issues? Are you grieving the loss of a loved one? Are you an empty-nester or senior trying to find yourself again & put joy back into your life? Do you have concerns about your children or your aging parents? Would you like to learn skills for coping & building self-esteem? Want to gain more control over negative emotions? Want to be more resilient, more confident, & happier? Call me.
I specialize in treating women going through challenging life transitions. Are you having difficulty in your marriage or relationship? Are you separated or going through a divorce & feeling sad & lost? Do you need support navigating work or school issues? Are you grieving the loss of a loved one? Are you an empty-nester or senior trying to find yourself again & put joy back into your life? Do you have concerns about your children or your aging parents? Would you like to learn skills for coping & building self-esteem? Want to gain more control over negative emotions? Want to be more resilient, more confident, & happier? Call me.
(843) 350-5457 View (843) 350-5457
Photo of Troy Schiedenhelm, Counselor, EdD, LPC/S, LCMHCS, CCMC
Troy Schiedenhelm
Counselor, EdD, LPC/S, LCMHCS, CCMC
2 Endorsed
Summerville, SC 29485
Evening Appointments Only - DBA Edisto Counseling & Consulting, LLC. - I enjoy working with individuals over 18 years of age who want and are motivated to be more than they are right now and are curious in discovering who they may be in their future. After the first 3 in-person counseling sessions (post-assessment), depending on the diagnosis and treatment plan, we can discuss a possible transition to an intermittent online/video counseling format, with in-person sessions being the primary mode of therapy.
Evening Appointments Only - DBA Edisto Counseling & Consulting, LLC. - I enjoy working with individuals over 18 years of age who want and are motivated to be more than they are right now and are curious in discovering who they may be in their future. After the first 3 in-person counseling sessions (post-assessment), depending on the diagnosis and treatment plan, we can discuss a possible transition to an intermittent online/video counseling format, with in-person sessions being the primary mode of therapy.
(843) 417-0036 View (843) 417-0036
Photo of Holly Bruhn, Clinical Social Work/Therapist, MSW, LISW-CP, MHA
Holly Bruhn
Clinical Social Work/Therapist, MSW, LISW-CP, MHA
Summerville, SC 29485
Holly Bruhn received her Master Degree in Social Work at Boston University. Through field placements in Boston, she gained experience working with adults in recovery from substance abuse and mental health problems in a Residential Treatment Facility setting. Since that time, Holly moved back to South Carolina and worked for a local mental health center as a school-based therapist in an elementary school. She also earned her Master Degree in Healthcare Administration from the Medical University of South Carolina. She has been working in private practice in the Charleston area for the past 22 years.
Holly Bruhn received her Master Degree in Social Work at Boston University. Through field placements in Boston, she gained experience working with adults in recovery from substance abuse and mental health problems in a Residential Treatment Facility setting. Since that time, Holly moved back to South Carolina and worked for a local mental health center as a school-based therapist in an elementary school. She also earned her Master Degree in Healthcare Administration from the Medical University of South Carolina. She has been working in private practice in the Charleston area for the past 22 years.
(843) 242-0726 View (843) 242-0726
Photo of Kathleen Pisani, Pre-Licensed Professional, MFT
Kathleen Pisani
Pre-Licensed Professional, MFT
Summerville, SC 29483
I am committed to helping couples and families grow happier together. I help couples navigate changes, rebuild emotional safety, repair trust, and discover intimacy. I am grounded in EFT, Gottman, Solution-Focused, and integrated sex therapy.
I am committed to helping couples and families grow happier together. I help couples navigate changes, rebuild emotional safety, repair trust, and discover intimacy. I am grounded in EFT, Gottman, Solution-Focused, and integrated sex therapy.
(854) 231-2705 View (854) 231-2705
Photo of Caitlin N Kirkland, Licensed Professional Counselor Associate, LPCA
Caitlin N Kirkland
Licensed Professional Counselor Associate, LPCA
2 Endorsed
Summerville, SC 29483
Are you exhausted from feeling like you're doing it all by yourself? You don't feel like you can even ask for help. You look at your life and all you see is chaos. You may feel like you're drowning and struggling to keep your head above water. So much has happened in your life leaving you in a place you never thought you'd be. Even the changes that we expect and welcome can leave us feeling overwhelmed and stressed out. You want to feel that you matter in this world and understand your purpose. You may be seeking help to navigate the parts of your life that no else seems to get. I want to help you find stability and confidence.
Are you exhausted from feeling like you're doing it all by yourself? You don't feel like you can even ask for help. You look at your life and all you see is chaos. You may feel like you're drowning and struggling to keep your head above water. So much has happened in your life leaving you in a place you never thought you'd be. Even the changes that we expect and welcome can leave us feeling overwhelmed and stressed out. You want to feel that you matter in this world and understand your purpose. You may be seeking help to navigate the parts of your life that no else seems to get. I want to help you find stability and confidence.
(854) 333-7871 View (854) 333-7871
Photo of Celena Richards, Licensed Professional Counselor, LPC
Celena Richards
Licensed Professional Counselor, LPC
3 Endorsed
Summerville, SC 29485
Waitlist for new clients
Hey there! I'm Celena! Just because you may think differently than others, or at least-have been told as much, doesn't mean that there is something wrong with you. We all process and feel things uniquely and at different rates. I'm here to help you sort through what you are experiencing in a way and at a speed that works for you. I understand that each person has their own complexities and quirks, and I believe that's what makes us human. While some people out there may not believe what you're feeling to be true, I'm here to listen to you and to help you so that you can move forward, cope, and/or feel like you again.
Hey there! I'm Celena! Just because you may think differently than others, or at least-have been told as much, doesn't mean that there is something wrong with you. We all process and feel things uniquely and at different rates. I'm here to help you sort through what you are experiencing in a way and at a speed that works for you. I understand that each person has their own complexities and quirks, and I believe that's what makes us human. While some people out there may not believe what you're feeling to be true, I'm here to listen to you and to help you so that you can move forward, cope, and/or feel like you again.
(843) 978-2791 View (843) 978-2791
Photo of Christine Collins, Licensed Professional Counselor Associate, MS, LPC-A
Christine Collins
Licensed Professional Counselor Associate, MS, LPC-A
Summerville, SC 29486
You’ve spent years showing up for everyone else—but now, something inside you is whispering (or screaming), "What about me?" I specialize in supporting Millennial and Gen X women who feel like they’ve lost themselves somewhere between marriage, motherhood, and career. You may be standing at a crossroads, burned out from the hundreds of tabs that never get to close, and thinking it might be too late to reclaim your purpose, your power, and your peace. I’m here to tell you: you’re just getting started. Let’s rewrite the story you’ve been told about what life is “supposed” to look like. You deserve a life that feels like your own.
You’ve spent years showing up for everyone else—but now, something inside you is whispering (or screaming), "What about me?" I specialize in supporting Millennial and Gen X women who feel like they’ve lost themselves somewhere between marriage, motherhood, and career. You may be standing at a crossroads, burned out from the hundreds of tabs that never get to close, and thinking it might be too late to reclaim your purpose, your power, and your peace. I’m here to tell you: you’re just getting started. Let’s rewrite the story you’ve been told about what life is “supposed” to look like. You deserve a life that feels like your own.
(843) 351-1804 x207 View (843) 351-1804 x207
Photo of Samm Brenner Gautier, Licensed Professional Counselor, MS, EdS, LPC, LPCS-C
Samm Brenner Gautier
Licensed Professional Counselor, MS, EdS, LPC, LPCS-C
2 Endorsed
Online Only
You’re driven and accomplished, but it doesn’t feel like enough. Stuck in a cycle of stress, self-doubt, and perfectionism, your mind races with what you “should” do better, leaving you burnt out and unsure of how to move forward. You want clarity—a way to quiet the noise, escape constant comparisons, and reconnect with purpose. Together, we’ll identify what’s working, what isn’t, and create meaningful, lasting changes so you feel confident, capable, and in control of building a life that feels balanced and fulfilling. You bring the determination, and I’ll guide the way.
You’re driven and accomplished, but it doesn’t feel like enough. Stuck in a cycle of stress, self-doubt, and perfectionism, your mind races with what you “should” do better, leaving you burnt out and unsure of how to move forward. You want clarity—a way to quiet the noise, escape constant comparisons, and reconnect with purpose. Together, we’ll identify what’s working, what isn’t, and create meaningful, lasting changes so you feel confident, capable, and in control of building a life that feels balanced and fulfilling. You bring the determination, and I’ll guide the way.
(803) 302-3634 View (803) 302-3634
Photo of Jeneen Walker, Licensed Professional Counselor Associate, LPC-A
Jeneen Walker
Licensed Professional Counselor Associate, LPC-A
Summerville, SC 29485
My ideal client is an adult, often a single parent, navigating anxiety, depression, life transitions, or co-parenting challenges. They are looking for a safe, compassionate space to be heard, gain clarity, and develop practical strategies for managing stress and emotions. Together, we work to strengthen relationships, build resilience, and create balance in personal, family, and work life. My goal is to help clients move from simply coping to truly thriving.
My ideal client is an adult, often a single parent, navigating anxiety, depression, life transitions, or co-parenting challenges. They are looking for a safe, compassionate space to be heard, gain clarity, and develop practical strategies for managing stress and emotions. Together, we work to strengthen relationships, build resilience, and create balance in personal, family, and work life. My goal is to help clients move from simply coping to truly thriving.
(843) 927-2120 View (843) 927-2120
Photo of Kim Reddout, Licensed Professional Counselor, MA, LPC
Kim Reddout
Licensed Professional Counselor, MA, LPC
1 Endorsed
Summerville, SC 29485
I love working with clients who are motivated to change. I want to help them get to the root of their problems and make their lives better. I love working with children, adults, families, and couples.
I love working with clients who are motivated to change. I want to help them get to the root of their problems and make their lives better. I love working with children, adults, families, and couples.
(843) 966-9472 View (843) 966-9472
Theodore Ruble
Licensed Professional Counselor
Summerville, SC 29486
Ted Ruble is a LPC, who has been practicing in counseling for 9 years. He graduated from McDaniel College in Westminster, Maryland with a Masters of Science in Community Mental Health Counseling. Ted believes in helping clients work through their issues using techniques such as Cognitive Behavioral Therapy in order to see new perspectives, or new ways of thinking about how they interact with the world around them. Ted believes in helping clients identify their own perosnal strengths that they can utilize in the helping the process of change. His main areas of focus are depression, anxiety, and dealing with life changes.
Ted Ruble is a LPC, who has been practicing in counseling for 9 years. He graduated from McDaniel College in Westminster, Maryland with a Masters of Science in Community Mental Health Counseling. Ted believes in helping clients work through their issues using techniques such as Cognitive Behavioral Therapy in order to see new perspectives, or new ways of thinking about how they interact with the world around them. Ted believes in helping clients identify their own perosnal strengths that they can utilize in the helping the process of change. His main areas of focus are depression, anxiety, and dealing with life changes.
(854) 220-0158 View (854) 220-0158
Photo of Kayla Stewart, Marriage & Family Therapist, MS, LMFT
Kayla Stewart
Marriage & Family Therapist, MS, LMFT
3 Endorsed
Summerville, SC 29485
I specialize in helping couples and families who are struggling with anxiety and disconnection in their relationships. You feel like the "emotional" one, like you're the only one who wants to fix things or talk about what's bothering you. You hate the anxiety you feel when issues linger, go unspoken, and get brushed under the rug. You try your best to get over it but the problem comes up over and over again. Some days you worry you'll end up divorced if things don't change soon. You want to come out of conversations feeling more connected and understood. You want less stress and worry in your marriage.
I specialize in helping couples and families who are struggling with anxiety and disconnection in their relationships. You feel like the "emotional" one, like you're the only one who wants to fix things or talk about what's bothering you. You hate the anxiety you feel when issues linger, go unspoken, and get brushed under the rug. You try your best to get over it but the problem comes up over and over again. Some days you worry you'll end up divorced if things don't change soon. You want to come out of conversations feeling more connected and understood. You want less stress and worry in your marriage.
(854) 850-4366 View (854) 850-4366
Photo of Mary Burcham - LifeStance Health, Clinical Social Work/Therapist, LISW-CP
LifeStance Health
Clinical Social Work/Therapist, LISW-CP
Summerville, SC 29483
Making your first appointment can be one of the most challenging steps in your mental health journey. At LifeStance, we make it simple by offering both online and in-person therapy and psychiatry services, covered by major insurance plans.
Making your first appointment can be one of the most challenging steps in your mental health journey. At LifeStance, we make it simple by offering both online and in-person therapy and psychiatry services, covered by major insurance plans.
(854) 237-0646 View (854) 237-0646
Photo of Nilsma Marshall, Licensed Professional Counselor
Nilsma Marshall
Licensed Professional Counselor
Summerville, SC 29483
Hello, I'm Nilsma. I specialize in helping individuals navigate trauma, anxiety, and depression. I firmly believe that emotional health is the cornerstone of a fulfilling life. When we are emotionally healthy, we can better manage stress, maintain physical health, foster meaningful relationships, enhance parenting skills, achieve our goals, enjoy life, boost our creativity, and be more productive in all areas, whether at home, work, or school. I hold a Master's degree and am a Licensed Addiction Counselor as well as a Licensed Professional Counselor.
Hello, I'm Nilsma. I specialize in helping individuals navigate trauma, anxiety, and depression. I firmly believe that emotional health is the cornerstone of a fulfilling life. When we are emotionally healthy, we can better manage stress, maintain physical health, foster meaningful relationships, enhance parenting skills, achieve our goals, enjoy life, boost our creativity, and be more productive in all areas, whether at home, work, or school. I hold a Master's degree and am a Licensed Addiction Counselor as well as a Licensed Professional Counselor.
(854) 227-3478 View (854) 227-3478
Photo of Shawnte Posley, Licensed Professional Counselor, LPC
Shawnte Posley
Licensed Professional Counselor, LPC
2 Endorsed
Summerville, SC 29485
Are you feeling overwhelmed, tense, or disconnected, even when life looks “fine” on the outside? Do you replay conversations, second-guess your decisions, or worry about saying too much—or not enough? Perhaps past family or relationship experiences still shape how safe, confident, or at ease you feel. You may carry anxiety, tension, or emotional shutdown in your body, even when you can articulate your patterns clearly, leaving you frustrated, stuck, or unsure how to move forward.
Are you feeling overwhelmed, tense, or disconnected, even when life looks “fine” on the outside? Do you replay conversations, second-guess your decisions, or worry about saying too much—or not enough? Perhaps past family or relationship experiences still shape how safe, confident, or at ease you feel. You may carry anxiety, tension, or emotional shutdown in your body, even when you can articulate your patterns clearly, leaving you frustrated, stuck, or unsure how to move forward.
(854) 888-9189 View (854) 888-9189
Photo of Kristal (Kristina) March, Licensed Professional Counselor, MA, LPC
Kristal (Kristina) March
Licensed Professional Counselor, MA, LPC
1 Endorsed
Summerville, SC 29486
I come from an Attachment background with expertise in ADHD in women and the dynamic and different ways it presents to this population. My passion and focus is in the support of men & women in their process of becoming, and accessing an empowered life. Together, we approach our negative self talk & thoughts gently and with deep compassion. We look to the past, uncovering the breadcrumbs we left along the way, to guide us back to where it all began. We see, hear, validate and love that precious inner child back to wholeness. Then life begins a new, with a solid foundation based in self compassion and self love.
I come from an Attachment background with expertise in ADHD in women and the dynamic and different ways it presents to this population. My passion and focus is in the support of men & women in their process of becoming, and accessing an empowered life. Together, we approach our negative self talk & thoughts gently and with deep compassion. We look to the past, uncovering the breadcrumbs we left along the way, to guide us back to where it all began. We see, hear, validate and love that precious inner child back to wholeness. Then life begins a new, with a solid foundation based in self compassion and self love.
(854) 215-2099 View (854) 215-2099
Photo of Magdalena Berrios, Licensed Professional Counselor Associate, LPCA
Magdalena Berrios
Licensed Professional Counselor Associate, LPCA
1 Endorsed
Summerville, SC 29483
I am committed to meeting my clients where they are, free from judgments, and always ready to listen. My therapeutic style is warm, non-judgmental, and collaborative. I like to utilize the strengths of Cognitive Behavioral Therapy and Client-Centered Therapy to empower and focus on individual needs, as well as motivational and solution-focused therapy.
I am committed to meeting my clients where they are, free from judgments, and always ready to listen. My therapeutic style is warm, non-judgmental, and collaborative. I like to utilize the strengths of Cognitive Behavioral Therapy and Client-Centered Therapy to empower and focus on individual needs, as well as motivational and solution-focused therapy.
(854) 946-5218 View (854) 946-5218
Photo of Jamie Kierpiec, Licensed Professional Counselor, MA, MFT, LPC
Jamie Kierpiec
Licensed Professional Counselor, MA, MFT, LPC
4 Endorsed
Summerville, SC 29483
Life isn’t always easy. Sometimes, even the strongest people need a little bit of help to work through life’s more challenging problems. Everyone has battles to fight and hurdles to overcome at some point. Whether you or a loved one struggle with anxiety, depression, trauma, or other hardships, you should know that there is hope for a better tomorrow. You might be initially hesitant to seek out help and support for personal matters, but when you do, you will feel confident that you are taking a courageous first step towards getting to a better place and being a better you.
Life isn’t always easy. Sometimes, even the strongest people need a little bit of help to work through life’s more challenging problems. Everyone has battles to fight and hurdles to overcome at some point. Whether you or a loved one struggle with anxiety, depression, trauma, or other hardships, you should know that there is hope for a better tomorrow. You might be initially hesitant to seek out help and support for personal matters, but when you do, you will feel confident that you are taking a courageous first step towards getting to a better place and being a better you.
(854) 855-5685 View (854) 855-5685

See more therapy options for Summerville

How does your Therapist compare?

Number of Therapists in Summerville, SC

300+

Average cost per session

$126

Therapists in Summerville, SC who prioritize treating:

93% Anxiety
93% Social Anxiety
93% Health Anxiety
93% Driving Anxiety
85% Depression
72% Stress
71% Relationship Issues

Average years in practice

10 Years

Top 3 insurances accepted

82% Aetna
75% Cigna and Evernorth
72% BlueCross and BlueShield

How Therapists in Summerville, SC see their clients

59% In Person and Online
41% Online Only

Gender breakdown

86% Female
14% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Summerville?

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.