Therapists in Fircrest, WA

Photo of Krista Franklin, Counselor in Fircrest, WA
Krista Franklin
Counselor, PsyD, MA, LMHCA
Verified Verified
Fircrest, WA 98466  (Online Only)
I am eager to see clients who are undergoing stress related to life changes, identity issues, managing mood instability or conflicts within the family, social, school or work realms. Additionally, my work experience includes helping those who are managing relationships with individuals who have mental health problems and/or have been incarcerated (often due to mental health problems).
I am eager to see clients who are undergoing stress related to life changes, identity issues, managing mood instability or conflicts within the family, social, school or work realms. Additionally, my work experience includes helping those who are managing relationships with individuals who have mental health problems and/or have been incarcerated (often due to mental health problems).
(206) 537-0501 View (206) 537-0501
Photo of Heather Jolley, Counselor in Fircrest, WA
Heather Jolley
Counselor, LMHC
Verified Verified
3 Endorsed
Fircrest, WA 98466  (Online Only)
Surviving something traumatic, experiencing grief and loss and growing up in chaotic homes are common challenges that leave us feeling different. Sometimes we are stuck in fight or flight, feeling disconnected or unsure of our true selves. Maybe you logically believe "I'm enough" or "I did the best I could" but emotionally, you struggle to believe it. Or maybe, you grew up always feeling responsible for your loved ones and you've been stuck in a people pleasing loop ever since. We can get stuck in patterns, ways of living and beliefs that no longer serve us and it can be hard to unlearn them on our own.
Surviving something traumatic, experiencing grief and loss and growing up in chaotic homes are common challenges that leave us feeling different. Sometimes we are stuck in fight or flight, feeling disconnected or unsure of our true selves. Maybe you logically believe "I'm enough" or "I did the best I could" but emotionally, you struggle to believe it. Or maybe, you grew up always feeling responsible for your loved ones and you've been stuck in a people pleasing loop ever since. We can get stuck in patterns, ways of living and beliefs that no longer serve us and it can be hard to unlearn them on our own.
(206) 516-2474 View (206) 516-2474
Photo of Family Foundations Counseling, Marriage & Family Therapist in Fircrest, WA
Family Foundations Counseling
Marriage & Family Therapist, MS, LMFT
Verified Verified
Fircrest, WA 98466
Choose from our counselors. See: www.ffctacoma.com. What's not working? What's painful enough that you'd like some help sorting through it? Family Foundations providers specialize in managing difficult circumstances and developing successful relationships with yourself and the important people in your life: significant-other, family, friends, peers, & co-workers. Please visit our website to learn more. We work with children, individuals, couples, and families. Together we'll learn and work toward ways to improve your life and relationships. See a list of providers by clicking on the website tab to the left.
Choose from our counselors. See: www.ffctacoma.com. What's not working? What's painful enough that you'd like some help sorting through it? Family Foundations providers specialize in managing difficult circumstances and developing successful relationships with yourself and the important people in your life: significant-other, family, friends, peers, & co-workers. Please visit our website to learn more. We work with children, individuals, couples, and families. Together we'll learn and work toward ways to improve your life and relationships. See a list of providers by clicking on the website tab to the left.
(253) 590-4235 View (253) 590-4235
Photo of Jaime DiGiovanna, Clinical Social Work/Therapist in Fircrest, WA
Jaime DiGiovanna
Clinical Social Work/Therapist, LICSW
Verified Verified
Fircrest, WA 98466
I have worked with a broad base of clients and stay grounded in a trauma informed, person-centered approach. I work with both teens and adults. In my career as a therapist, I has worked with patients ranging in age from 6 years old to over 70 in a variety of environments. I see each of my patients as the expert of their own lives.
I have worked with a broad base of clients and stay grounded in a trauma informed, person-centered approach. I work with both teens and adults. In my career as a therapist, I has worked with patients ranging in age from 6 years old to over 70 in a variety of environments. I see each of my patients as the expert of their own lives.
(253) 263-1902 View (253) 263-1902
Photo of Kim Bjorn, Clinical Social Work/Therapist in Fircrest, WA
Kim Bjorn
Clinical Social Work/Therapist, LICSW
Verified Verified
Fircrest, WA 98466
Waitlist for new clients
People who seek me out tend to feel stuck, blocked and very ready to have something different in life. Vitality and joy have been sucked out of you with anxiety and sadness remaining. It really sucks feeling this way and everyday is on repeat. No one wants to be around you, you don't even want to be around yourself. Either you are fading into your surroundings and have no voice to exclaim your existence or your irritable, angry energy pushes people away. Talking to someone will likely help you - however, changing thoughts, feelings and behaviors will make the difference. Action is required to regain happiness and wholeness.
People who seek me out tend to feel stuck, blocked and very ready to have something different in life. Vitality and joy have been sucked out of you with anxiety and sadness remaining. It really sucks feeling this way and everyday is on repeat. No one wants to be around you, you don't even want to be around yourself. Either you are fading into your surroundings and have no voice to exclaim your existence or your irritable, angry energy pushes people away. Talking to someone will likely help you - however, changing thoughts, feelings and behaviors will make the difference. Action is required to regain happiness and wholeness.
(253) 367-3798 View (253) 367-3798
Photo of Jennifer Evinger PLLC, Counselor in Fircrest, WA
Jennifer Evinger PLLC
Counselor, LMHC, CMHS
Verified Verified
14 Endorsed
Fircrest, WA 98466
It can be a challenge to find a counselor that is not only a good fit, but has the knowledge to help with the concerns you are bringing to therapy. I work with both both children and adults in my practice and have spent the past 10 years specializing in treating depression, anxiety, behavioral concerns in children, and trauma/PTSD using evidence-based treatments. Clients have described me as straight-forward as well as taking the time to understand their experience.
It can be a challenge to find a counselor that is not only a good fit, but has the knowledge to help with the concerns you are bringing to therapy. I work with both both children and adults in my practice and have spent the past 10 years specializing in treating depression, anxiety, behavioral concerns in children, and trauma/PTSD using evidence-based treatments. Clients have described me as straight-forward as well as taking the time to understand their experience.
(253) 785-6569 View (253) 785-6569
Photo of Summer Stullick, Counselor in Fircrest, WA
Summer Stullick
Counselor, MS, LMHC, MHP, CCTP
Verified Verified
Fircrest, WA 98466  (Online Only)
Telehealth Only: Accepting Clients: I work with clients who are motivated to become the best version of themselves and find ways to manage and keep balance with their mental health. I look at various aspects of wellness that contribute to your self-care and mental health, help understand where your thoughts and behaviors are stemming from, find ways to cope through life's challenges, and gain insight and reflection into yourself. I will help you gain the skills, knowledge, and confidence to implement positive change in your life by tapping into your strengths, resources, and helping you identify your next steps.
Telehealth Only: Accepting Clients: I work with clients who are motivated to become the best version of themselves and find ways to manage and keep balance with their mental health. I look at various aspects of wellness that contribute to your self-care and mental health, help understand where your thoughts and behaviors are stemming from, find ways to cope through life's challenges, and gain insight and reflection into yourself. I will help you gain the skills, knowledge, and confidence to implement positive change in your life by tapping into your strengths, resources, and helping you identify your next steps.
(253) 400-2825 View (253) 400-2825
Photo of Kathryn S Crabb, Counselor in Fircrest, WA
Kathryn S Crabb
Counselor, MA, LMHC
Verified Verified
2 Endorsed
Fircrest, WA 98466
Waitlist for new clients
All of us, including you, were born with a core self that’s vibrant, inviolable, and indomitable. It’s still there inside, waiting patiently for each of us to work through the layers of difficulties, frustrations, and self-doubt that have accumulated over the years. When we do that difficult work, we’re able to live more from the core self and less from the wounded layer that so many of us have adopted out of painful necessity. In therapy we'll clarify confusions, heal the hurt places, and connect with your core self so you can live with more ease, truth, and self-love.
All of us, including you, were born with a core self that’s vibrant, inviolable, and indomitable. It’s still there inside, waiting patiently for each of us to work through the layers of difficulties, frustrations, and self-doubt that have accumulated over the years. When we do that difficult work, we’re able to live more from the core self and less from the wounded layer that so many of us have adopted out of painful necessity. In therapy we'll clarify confusions, heal the hurt places, and connect with your core self so you can live with more ease, truth, and self-love.
(253) 655-2688 View (253) 655-2688
Photo of Kelly K Brown, Psychologist in Fircrest, WA
Kelly K Brown
Psychologist, PhD
Verified Verified
Fircrest, WA 98466
Hello, my name is Dr. Brown. My office is located in Fircrest, WA between Tacoma and University Place. I'm so glad you've decided to begin this journey of self-discovery and healing. I use a client-centered approach, collaborating with the client to develop self-awareness, healthy coping skills, and healing. I have specialized training from The Center for Multicultural Training in Psychology and can work with any issue related to diverse identities, sexuality, and relationships. I use EMDR in my practice, a technique helpful in working with trauma.
Hello, my name is Dr. Brown. My office is located in Fircrest, WA between Tacoma and University Place. I'm so glad you've decided to begin this journey of self-discovery and healing. I use a client-centered approach, collaborating with the client to develop self-awareness, healthy coping skills, and healing. I have specialized training from The Center for Multicultural Training in Psychology and can work with any issue related to diverse identities, sexuality, and relationships. I use EMDR in my practice, a technique helpful in working with trauma.
(253) 364-1462 View (253) 364-1462
Photo of Dawn Lindsay, Mental Health Counselor in Fircrest, WA
Dawn Lindsay
Mental Health Counselor, LMHC, MA, MHP
Verified Verified
13 Endorsed
Fircrest, WA 98466
You have quietly suffered for too long. You have faced a pain that is so dark and deep you haven’t thought about it in years. You’ve managed to bury the trauma enough to carry on with your life. People look at you and think, “They have got it all together.” But the pain is starting to surface. The past is catching up, and you can’t outrun it this time. You’re ready now. You’re ready to face the darkness and experience true healing. The good news is, you don’t have to face it alone.
You have quietly suffered for too long. You have faced a pain that is so dark and deep you haven’t thought about it in years. You’ve managed to bury the trauma enough to carry on with your life. People look at you and think, “They have got it all together.” But the pain is starting to surface. The past is catching up, and you can’t outrun it this time. You’re ready now. You’re ready to face the darkness and experience true healing. The good news is, you don’t have to face it alone.
(253) 300-0905 View (253) 300-0905
Photo of Ginger Ingersoll MacDuff, Counselor in Fircrest, WA
Ginger Ingersoll MacDuff
Counselor, LMHC, LBA, BCBA
Verified Verified
1 Endorsed
Fircrest, WA 98466
Are you seeking compassionate support? Look no further! As a seasoned therapist, I offer individual and family therapy services with a neurodiversity focus. Whether you’re a teen, young adult, or a family in transition, I’m here for you. Let’s navigate life’s challenges together. Autism Support: Families and individuals impacted by autism find a safe space here. I am highly trained and experienced in working with autism. Transition Guidance: Whether it’s adolescence or major life changes (divorce, moving, etc), I’ve got your back. Discover your strengths, embrace your uniqueness, and thrive! Contact me today.
Are you seeking compassionate support? Look no further! As a seasoned therapist, I offer individual and family therapy services with a neurodiversity focus. Whether you’re a teen, young adult, or a family in transition, I’m here for you. Let’s navigate life’s challenges together. Autism Support: Families and individuals impacted by autism find a safe space here. I am highly trained and experienced in working with autism. Transition Guidance: Whether it’s adolescence or major life changes (divorce, moving, etc), I’ve got your back. Discover your strengths, embrace your uniqueness, and thrive! Contact me today.
(253) 215-8804 View (253) 215-8804
Photo of Tammy Tangen, Counselor in Fircrest, WA
Tammy Tangen
Counselor, LMHC, MHP
Verified Verified
6 Endorsed
Fircrest, WA 98466
As a therapist, I'm passionate about providing my clients with a safe, trusting, kind and understanding place to work through their most pressing concerns. For over 10 years I've used evidence-based and solution-focused therapy to help my clients build the tools and techniques that have been proven effective in navigating the difficulties of life.
As a therapist, I'm passionate about providing my clients with a safe, trusting, kind and understanding place to work through their most pressing concerns. For over 10 years I've used evidence-based and solution-focused therapy to help my clients build the tools and techniques that have been proven effective in navigating the difficulties of life.
(253) 201-4189 View (253) 201-4189
Photo of Sally H Kim, Clinical Social Work/Therapist in Fircrest, WA
Sally H Kim
Clinical Social Work/Therapist, LSWAIC, MSW
Verified Verified
Fircrest, WA 98466
Not accepting new clients
Feeling unsteady, lost, overwhelmed? Work, home, family becoming a lot? Does it feel like it's all on you, alone? Seems hard to move, or maybe, it's hard to stop moving because you're afraid of what might happen if you slowed down, if you paused? Maybe it all started with a loss of a loved one, a job transition, a break-up, new relationship, or when you had children. Maybe it started long ago, and it's painful to think about. Whenever it started, did you lose yourself along the way? Are you wondering if you'll be able to enjoy relationships, work, home, yourself, again, or how you'll trust your ability to survive and thrive?
Feeling unsteady, lost, overwhelmed? Work, home, family becoming a lot? Does it feel like it's all on you, alone? Seems hard to move, or maybe, it's hard to stop moving because you're afraid of what might happen if you slowed down, if you paused? Maybe it all started with a loss of a loved one, a job transition, a break-up, new relationship, or when you had children. Maybe it started long ago, and it's painful to think about. Whenever it started, did you lose yourself along the way? Are you wondering if you'll be able to enjoy relationships, work, home, yourself, again, or how you'll trust your ability to survive and thrive?
(253) 352-2988 View (253) 352-2988
Photo of Clairemarie Clark, Psychologist in Fircrest, WA
Clairemarie Clark
Psychologist, PhD, MA
Verified Verified
1 Endorsed
Fircrest, WA 98466  (Online Only)
Not accepting new clients
*Not Currently Accepting New Clients* Are you feeling lost, stuck, or overwhelmed? I can guide you in exploring these issues while helping you to identify and access your inner strengths and resources for healing and growth. I specialize in working with people who are struggling with stress and overwhelm, a lack of meaning and purpose, and low self-worth issues. As one myself, I also have insight and understanding treating Global Nomads, Third Culture Kids, Expats, and people who deal with issues relating to frequent moves and relocations. I value diversity and inclusivity. I aim to provide a safe, welcoming space for all people.
*Not Currently Accepting New Clients* Are you feeling lost, stuck, or overwhelmed? I can guide you in exploring these issues while helping you to identify and access your inner strengths and resources for healing and growth. I specialize in working with people who are struggling with stress and overwhelm, a lack of meaning and purpose, and low self-worth issues. As one myself, I also have insight and understanding treating Global Nomads, Third Culture Kids, Expats, and people who deal with issues relating to frequent moves and relocations. I value diversity and inclusivity. I aim to provide a safe, welcoming space for all people.
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Photo of Katherine McCaffree, Counselor in Fircrest, WA
Katherine McCaffree
Counselor, LMHC, LMFTA
Verified Verified
Fircrest, WA 98466  (Online Only)
I strongly believe that all clients are unique in their circumstances and needs. I believe that therapy is best done as a collaborative process between counselor and client. My goal is to build a partnership with you in which we can explore your thoughts, feelings, and ways of being in the world in a deeper way. I encourage my clients to find ways of being their best and most authentic selves and help them challenge beliefs and feelings that prevent them from doing so.
I strongly believe that all clients are unique in their circumstances and needs. I believe that therapy is best done as a collaborative process between counselor and client. My goal is to build a partnership with you in which we can explore your thoughts, feelings, and ways of being in the world in a deeper way. I encourage my clients to find ways of being their best and most authentic selves and help them challenge beliefs and feelings that prevent them from doing so.
(253) 487-0252 View (253) 487-0252
Photo of Annalise Hertler, Clinical Social Work/Therapist in Fircrest, WA
Annalise Hertler
Clinical Social Work/Therapist, LICSW
Verified Verified
2 Endorsed
Fircrest, WA 98466
Waitlist for new clients
Whether it be navigating a stressful life transition, feeling out of control in your environment, or finally feeling ready to process your past—everyone could use some additional support sometimes. Whatever it may be, we can figure it out together! My practice is centered around a client focused, strengths based, and trauma informed perspective. At my core I believe that the therapeutic alliance and relationship are integral to the success of an intervention, and I enjoy utilizing humor to strengthen and develop the therapeutic relationship!
Whether it be navigating a stressful life transition, feeling out of control in your environment, or finally feeling ready to process your past—everyone could use some additional support sometimes. Whatever it may be, we can figure it out together! My practice is centered around a client focused, strengths based, and trauma informed perspective. At my core I believe that the therapeutic alliance and relationship are integral to the success of an intervention, and I enjoy utilizing humor to strengthen and develop the therapeutic relationship!
(253) 364-4189 View (253) 364-4189
Photo of Primrose Therapeutic Services , Pre-Licensed Professional in Fircrest, WA
Primrose Therapeutic Services
Pre-Licensed Professional, LSWAIC, MSW
Verified Verified
Fircrest, WA 98466  (Online Only)
Waitlist for new clients
Hello! I am Natalia and as a licensed therapist in the state of Washington, I provide services to individuals who seek to improve their everyday life by creating self-awareness and body-mind connection through therapy and mindfulness. I aim to help individuals recognize the negative and positive patterns and work together to improve or reinforce them.
Hello! I am Natalia and as a licensed therapist in the state of Washington, I provide services to individuals who seek to improve their everyday life by creating self-awareness and body-mind connection through therapy and mindfulness. I aim to help individuals recognize the negative and positive patterns and work together to improve or reinforce them.
(253) 465-2617 View (253) 465-2617
Photo of Tim Neumann, Counselor in Fircrest, WA
Tim Neumann
Counselor, MA, LMHCA, CMHS, CIMHP
Verified Verified
Fircrest, WA 98466  (Online Only)
Not accepting new clients
I am a white, neurodivergent, pansexual, cismale, and 3rd generation Italian-North European immigrant living on Puyallup / Steilacoom lands (Fircrest, WA) but born and raised in Očhéthi Šakówiŋ / Wahpekute lands (Minneapolis, MN). I work from a place that acknowledges my own identity and privileges in effort to help clients address their own identity, struggles, and role in systems of oppression. I value activism and allyship including addressing political issues directly in my work, examining my own assumptions and blind spots, and working to always increase my awareness of oppression and systemic issues.
I am a white, neurodivergent, pansexual, cismale, and 3rd generation Italian-North European immigrant living on Puyallup / Steilacoom lands (Fircrest, WA) but born and raised in Očhéthi Šakówiŋ / Wahpekute lands (Minneapolis, MN). I work from a place that acknowledges my own identity and privileges in effort to help clients address their own identity, struggles, and role in systems of oppression. I value activism and allyship including addressing political issues directly in my work, examining my own assumptions and blind spots, and working to always increase my awareness of oppression and systemic issues.
(253) 465-7640 View (253) 465-7640
Photo of Julie Stewart, Counselor in Fircrest, WA
Julie Stewart
Counselor, LMHC, CN, MS
Verified Verified
Fircrest, WA 98466  (Online Only)
We all need compassionate connection to grow and heal, and that is especially important in therapy. I provide a connection that is warm, yet intellectual, making sure to challenge your mind and heart for growth, support, and ultimately deeper relationships. I'm a good match for recovering perfectionists, women with ADHD/autism, anxiety concerns, depression, and those wanting support around chronic health conditions.
We all need compassionate connection to grow and heal, and that is especially important in therapy. I provide a connection that is warm, yet intellectual, making sure to challenge your mind and heart for growth, support, and ultimately deeper relationships. I'm a good match for recovering perfectionists, women with ADHD/autism, anxiety concerns, depression, and those wanting support around chronic health conditions.
(206) 339-3354 View (206) 339-3354
Photo of April Luman, Counselor in Fircrest, WA
April Luman
Counselor, MA, LMHC
Verified Verified
Fircrest, WA 98466
Hi there! I am a licensed mental health counselor in Washington with twelve years of experience working in a variety of mental health programs. I have worked with clients with a wide range of concerns such as depression, anxiety, behavioral issues, relationship issues, parenting skills, and have additional training specializing in work with trauma.
Hi there! I am a licensed mental health counselor in Washington with twelve years of experience working in a variety of mental health programs. I have worked with clients with a wide range of concerns such as depression, anxiety, behavioral issues, relationship issues, parenting skills, and have additional training specializing in work with trauma.
(253) 400-2733 View (253) 400-2733

See more therapy options for Fircrest

How does your Therapist compare?

Number of Therapists in Fircrest, WA

30+

Average cost per session

$147

Therapists in Fircrest, WA who prioritize treating:

95% Depression
95% Anxiety
81% Trauma and PTSD
81% Coping Skills
81% Stress
78% Relationship Issues
78% Self Esteem

Average years in practice

10 Years

Top 3 insurances accepted

85% Premera
67% First Choice Health | FCH
67% Regence

How Therapists in Fircrest, WA see their clients

60% In Person and Online
40% Online Only

Gender breakdown

89% Female
9% Male
2% Non-Binary

FAQs - About Therapy and Counseling

How can I find a therapist in Fircrest?

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.