Therapists in Saint Clair Shores, MI

Photo of Loretta Mitton, Limited Licensed Psychologist in Saint Clair Shores, MI
Loretta Mitton
Limited Licensed Psychologist, MA, LLP
Verified Verified
Saint Clair Shores, MI 48080
My goal is to assist individuals who are facing life's challenges and help them recognize their worth and their potential. I do this through compassionate listening and insightful direction that ultimately provides my clients with the empowerment they need to experience healing and growth. Whether you are looking for someone to help you through depression, anxiety or merely the daily challenge of living, I will do my best to meet you where you are and tailor my therapeutic approach to assist you on your journey. I also specialize in couple's therapy and have a passion for healthy marriages.
My goal is to assist individuals who are facing life's challenges and help them recognize their worth and their potential. I do this through compassionate listening and insightful direction that ultimately provides my clients with the empowerment they need to experience healing and growth. Whether you are looking for someone to help you through depression, anxiety or merely the daily challenge of living, I will do my best to meet you where you are and tailor my therapeutic approach to assist you on your journey. I also specialize in couple's therapy and have a passion for healthy marriages.
(586) 799-2814 View (586) 799-2814
Photo of Jennifer Mercer, Licensed Professional Counselor in Saint Clair Shores, MI
Jennifer Mercer
Licensed Professional Counselor, LPC
Verified Verified
Saint Clair Shores, MI 48080
I have been providing individual, family and couples counseling for over 10 years. Specializing in Relationship Issues, Divorce/Marital Issues, Polyamorous Couples, Family Issues/Blended Families, Life Transitions, Anxiety Disorders, Depression, Stress Management, Anger Management, ADD/ADHD, Grief/Bereavement, Oppositional Defiant/Behavioral Challenges and Workplace Issues. It's an honor to help you individually in reaching your personal goals and/or as a family/couple in strengthening the foundation of your family.
I have been providing individual, family and couples counseling for over 10 years. Specializing in Relationship Issues, Divorce/Marital Issues, Polyamorous Couples, Family Issues/Blended Families, Life Transitions, Anxiety Disorders, Depression, Stress Management, Anger Management, ADD/ADHD, Grief/Bereavement, Oppositional Defiant/Behavioral Challenges and Workplace Issues. It's an honor to help you individually in reaching your personal goals and/or as a family/couple in strengthening the foundation of your family.
(586) 788-0995 View (586) 788-0995
Photo of Jaycie Gauci, Clinical Social Work/Therapist in Saint Clair Shores, MI
Jaycie Gauci
Clinical Social Work/Therapist, LMSW, CIMHP
Verified Verified
Saint Clair Shores, MI 48080  (Online Only)
Our mental and physical health are closely connected, and achieving a balance between the two can be key to living a happier, more fulfilling life. Whether you're dealing with stress, anxiety, depression, or simply looking to create healthier habits, I'm here to guide you on your journey toward better overall well-being.
Our mental and physical health are closely connected, and achieving a balance between the two can be key to living a happier, more fulfilling life. Whether you're dealing with stress, anxiety, depression, or simply looking to create healthier habits, I'm here to guide you on your journey toward better overall well-being.
(586) 281-5543 View (586) 281-5543
Photo of Brenda C Carney, Clinical Social Work/Therapist in Saint Clair Shores, MI
Brenda C Carney
Clinical Social Work/Therapist, LMSW
Verified Verified
Saint Clair Shores, MI 48080  (Online Only)
Hello, I'm Brenda Carney, a Licensed Master Social Worker who earned my degree from Wayne State University. My entire career has been dedicated to supporting the Metro Detroit community. As a therapist, my passion lies in helping individuals within my community improve their well-being. I see all clients virtually.
Hello, I'm Brenda Carney, a Licensed Master Social Worker who earned my degree from Wayne State University. My entire career has been dedicated to supporting the Metro Detroit community. As a therapist, my passion lies in helping individuals within my community improve their well-being. I see all clients virtually.
(313) 513-6513 View (313) 513-6513
Photo of Eboni S. Patterson, Pre-Licensed Professional in Saint Clair Shores, MI
Eboni S. Patterson
Pre-Licensed Professional
Verified Verified
3 Endorsed
Saint Clair Shores, MI 48080
The therapeutic relationship is one of the key components in therapy. One of my goals is to make sure the client and myself have a good rapport which can make the transition into therapy less stressful. I approach each client as an individual based on the needs and concerns presented. I utilize a variety of theoretical perspectives in order to best fit the client. My theoretical experience includes CBT, mindfulness based, Adlerian and trauma- informed.
The therapeutic relationship is one of the key components in therapy. One of my goals is to make sure the client and myself have a good rapport which can make the transition into therapy less stressful. I approach each client as an individual based on the needs and concerns presented. I utilize a variety of theoretical perspectives in order to best fit the client. My theoretical experience includes CBT, mindfulness based, Adlerian and trauma- informed.
(586) 400-2065 View (586) 400-2065
Photo of Kayla Nabozny, Counselor in Saint Clair Shores, MI
Kayla Nabozny
Counselor
Verified Verified
2 Endorsed
Saint Clair Shores, MI 48081
I believe that it is healthy and natural for people to attend counseling. I view therapy as a partnership between client and therapist, both working towards an agreed upon goal. Every counseling session is entered with optimism and open mindedness. I received my Master’s degree from Oakland University in Clinical Mental Health Counseling.
I believe that it is healthy and natural for people to attend counseling. I view therapy as a partnership between client and therapist, both working towards an agreed upon goal. Every counseling session is entered with optimism and open mindedness. I received my Master’s degree from Oakland University in Clinical Mental Health Counseling.
(586) 300-1456 View (586) 300-1456
Photo of Katie Potts, Clinical Social Work/Therapist in Saint Clair Shores, MI
Katie Potts
Clinical Social Work/Therapist, LMSW
Verified Verified
Saint Clair Shores, MI 48080  (Online Only)
Hello and Welcome, I am so glad you found me! if you are someone who has been thinking of starting counseling I am glad you found me. I help all types of people including men and women who want to be able to navigate challenges in their life and know how to skillfully handle stressful situations and reduce feelings of burnout and overwhelm! I can help people that struggle with anxiety, depression, PTSD, relationship struggles, singles, and couples.
Hello and Welcome, I am so glad you found me! if you are someone who has been thinking of starting counseling I am glad you found me. I help all types of people including men and women who want to be able to navigate challenges in their life and know how to skillfully handle stressful situations and reduce feelings of burnout and overwhelm! I can help people that struggle with anxiety, depression, PTSD, relationship struggles, singles, and couples.
(586) 551-7156 View (586) 551-7156
Photo of Erz Psychotherapy Services, P.C., Limited Licensed Psychologist in Saint Clair Shores, MI
Erz Psychotherapy Services, P.C.
Limited Licensed Psychologist
Verified Verified
Saint Clair Shores, MI 48080  (Online Only)
Hi. My name is Kathleen Erz. I am the owner of Erz Psychotherapy Services. I believe direct, honest, and caring communication is essential to effective therapy. I tend to have a straight-forward approach with people. Often old patterns of behavior or thinking get in the way of experiencing our potential. It is my job to help my clients get over their hurdles and through blocks in order to help them experience happiness.
Hi. My name is Kathleen Erz. I am the owner of Erz Psychotherapy Services. I believe direct, honest, and caring communication is essential to effective therapy. I tend to have a straight-forward approach with people. Often old patterns of behavior or thinking get in the way of experiencing our potential. It is my job to help my clients get over their hurdles and through blocks in order to help them experience happiness.
(586) 209-2657 View (586) 209-2657
Photo of Jules Pangborn-Harley, Licensed Professional Counselor in Saint Clair Shores, MI
Jules Pangborn-Harley
Licensed Professional Counselor, LPC, ATR-P
Verified Verified
Saint Clair Shores, MI 48080
Accepting New Clients! Please no Meridian Medicaid! I am a licensed professional counselor and art therapist. I have dedicated my career to helping traumatized children, teens and their families heal through art therapy and counseling. I have worked in various environments, from home-based work to outpatient (office) settings in counseling. If you or someone you know has a child or teenager that is struggling with mental illness and trauma, send them my way! I am confident that my eclectic approach to counseling and art therapy will help you and your children heal and grow throughout life's journey.
Accepting New Clients! Please no Meridian Medicaid! I am a licensed professional counselor and art therapist. I have dedicated my career to helping traumatized children, teens and their families heal through art therapy and counseling. I have worked in various environments, from home-based work to outpatient (office) settings in counseling. If you or someone you know has a child or teenager that is struggling with mental illness and trauma, send them my way! I am confident that my eclectic approach to counseling and art therapy will help you and your children heal and grow throughout life's journey.
(586) 315-4912 View (586) 315-4912
Photo of Maria Merritt, Clinical Social Work/Therapist in Saint Clair Shores, MI
Maria Merritt
Clinical Social Work/Therapist, LMSW
Verified Verified
Saint Clair Shores, MI 48080
Maria works with individuals who are looking to gain insight into themselves and improve their quality of life. She seeks to understand each individual holistically, including their backgrounds and the strengths they already possess to provide an individualized approach. Maria believes that establishing a strong alliance with her clients is essential to getting the most out of therapy and creating lasting change. Through this alliance, she partners with her clients to explore and address thought and behavior patterns that serve as barriers to enjoying life fully.
Maria works with individuals who are looking to gain insight into themselves and improve their quality of life. She seeks to understand each individual holistically, including their backgrounds and the strengths they already possess to provide an individualized approach. Maria believes that establishing a strong alliance with her clients is essential to getting the most out of therapy and creating lasting change. Through this alliance, she partners with her clients to explore and address thought and behavior patterns that serve as barriers to enjoying life fully.
(586) 257-2776 View (586) 257-2776
Photo of Angel Marsiglio, Clinical Social Work/Therapist in Saint Clair Shores, MI
Angel Marsiglio
Clinical Social Work/Therapist, LMSW
Verified Verified
Saint Clair Shores, MI 48080
Angel Marsiglio is a Mastered Licensed Social Worker. She graduated from Wayne State University. She obtained both a Bachelor's and Master's of Social Work degrees. Angel believes in Client Centered Therapy which focuses on daily anxieties, stressors and other symptoms. She also believes in understanding behaviors, past and present that impact current functioning. She creates a warm, safe space to set goals and create realistic, achievable objectives. Her main areas of focus includes grief, trauma, women's issues, anxiety and depression.
Angel Marsiglio is a Mastered Licensed Social Worker. She graduated from Wayne State University. She obtained both a Bachelor's and Master's of Social Work degrees. Angel believes in Client Centered Therapy which focuses on daily anxieties, stressors and other symptoms. She also believes in understanding behaviors, past and present that impact current functioning. She creates a warm, safe space to set goals and create realistic, achievable objectives. Her main areas of focus includes grief, trauma, women's issues, anxiety and depression.
(586) 210-3012 View (586) 210-3012
Photo of Rachel Young, Clinical Social Work/Therapist in Saint Clair Shores, MI
Rachel Young
Clinical Social Work/Therapist, LMSW, CAADC, CCTS-I
Verified Verified
3 Endorsed
Saint Clair Shores, MI 48080
Waitlist for new clients
Currently, I am accepting new clients for Accelerated Resolution Therapy, ART. I have familiarity working with individuals with a variety of mental health concerns including anxiety, depression, trauma, stress from significant life changes, and substance use. I provide clients with a person-centered approach that is affirming and nonjudgmental. I strive to be sex positive, culturally sensitive, and LGBTQ+ affirming. I understand that there is no one-size-fits-all approach to therapy. I incorporate a blend of many different approaches to ensure that you are receiving the best possible care for you.
Currently, I am accepting new clients for Accelerated Resolution Therapy, ART. I have familiarity working with individuals with a variety of mental health concerns including anxiety, depression, trauma, stress from significant life changes, and substance use. I provide clients with a person-centered approach that is affirming and nonjudgmental. I strive to be sex positive, culturally sensitive, and LGBTQ+ affirming. I understand that there is no one-size-fits-all approach to therapy. I incorporate a blend of many different approaches to ensure that you are receiving the best possible care for you.
(586) 500-7436 View (586) 500-7436
Photo of Agnes Ward, Psychologist in Saint Clair Shores, MI
Agnes Ward
Psychologist, PhD
Verified Verified
Saint Clair Shores, MI 48082
I provide psychotherapy to children, adolescents, adults, couples, and families. I focus on treating depression, anxiety, trauma, grief and loss, marital and family issues, behavioral problems, and personality disorders. I also treat children with Asperger's Disorder, ADHD, and social skills deficits. I have had extensive training in the treatment of eating disorders including anorexia, bulimia, and binge eating disorders. I am committed to providing the latest and highest quality of research-supported treatment to help cope with life's demands and stressors, as well as help you improve your functioning and reach your fullest potential.
I provide psychotherapy to children, adolescents, adults, couples, and families. I focus on treating depression, anxiety, trauma, grief and loss, marital and family issues, behavioral problems, and personality disorders. I also treat children with Asperger's Disorder, ADHD, and social skills deficits. I have had extensive training in the treatment of eating disorders including anorexia, bulimia, and binge eating disorders. I am committed to providing the latest and highest quality of research-supported treatment to help cope with life's demands and stressors, as well as help you improve your functioning and reach your fullest potential.
(586) 804-7908 View (586) 804-7908
Photo of Lexie Garfield-Turner, Clinical Social Work/Therapist in Saint Clair Shores, MI
Lexie Garfield-Turner
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
2 Endorsed
Saint Clair Shores, MI 48080
Is your mind constantly screaming that your body is too big, too small, too curvy? Do your days revolve around meal planning & exercising to ensure the scale changes? If you find yourself consistently thinking about food, the calories you need to burn off after a "cheat meal," or you're hyper-focused on the bodies that spawn social media, my associates and I are here for you. We are here to teach you to love and accept the body you were given; to nourish that body without obsessing over the details; & to help you discover where the root of your disappointment comes from.
Is your mind constantly screaming that your body is too big, too small, too curvy? Do your days revolve around meal planning & exercising to ensure the scale changes? If you find yourself consistently thinking about food, the calories you need to burn off after a "cheat meal," or you're hyper-focused on the bodies that spawn social media, my associates and I are here for you. We are here to teach you to love and accept the body you were given; to nourish that body without obsessing over the details; & to help you discover where the root of your disappointment comes from.
(248) 565-3197 View (248) 565-3197
Photo of Anna Skardoutos, Counselor in Saint Clair Shores, MI
Anna Skardoutos
Counselor, MA, LPC
Verified Verified
7 Endorsed
Saint Clair Shores, MI 48080  (Online Only)
Waitlist for new clients
When meeting with a client, I take great pride in working as a team to process trauma, increase self-worth, and develop new and appropriate coping skills to reach therapeutic and life goals in a safe and positive way. I enjoy experiencing the growth of a therapeutic relationship, and providing a comfortable, friendly, safe environment to assist clients in learning to survive and thrive through difficult times, and make changes in their lives that they are proud of.
When meeting with a client, I take great pride in working as a team to process trauma, increase self-worth, and develop new and appropriate coping skills to reach therapeutic and life goals in a safe and positive way. I enjoy experiencing the growth of a therapeutic relationship, and providing a comfortable, friendly, safe environment to assist clients in learning to survive and thrive through difficult times, and make changes in their lives that they are proud of.
(586) 501-8974 View (586) 501-8974
Photo of Damon Moore, Limited Licensed Psychologist in Saint Clair Shores, MI
Damon Moore
Limited Licensed Psychologist, MA, TLLP
Verified Verified
Saint Clair Shores, MI 48080  (Online Only)
If you could runaway you would. (╥....╥)Things are overwhelming. Almost nothing is going right. You don't know which direction to choose and you feel stuck. If only you knew how to escape the same unhealthy patterns that you're trapped in...If only you knew what to say...If only you knew when to say it...If only you knew what to do and when to do it...If only you knew how to peel yourself off of life's boot you might be able to really accomplish the dreams you once had. Those hopes and childhood dreams are not as far as you once thought. Let me show you
If you could runaway you would. (╥....╥)Things are overwhelming. Almost nothing is going right. You don't know which direction to choose and you feel stuck. If only you knew how to escape the same unhealthy patterns that you're trapped in...If only you knew what to say...If only you knew when to say it...If only you knew what to do and when to do it...If only you knew how to peel yourself off of life's boot you might be able to really accomplish the dreams you once had. Those hopes and childhood dreams are not as far as you once thought. Let me show you
(586) 776-3366 View (586) 776-3366
Carissa L Gaden
Psychologist, PhD
Verified Verified
1 Endorsed
Saint Clair Shores, MI 48081
My private practice includes work with adults, adolescents and couples, with a specialty in adolescence and young adulthood. I have particular experience in treating depression, eating disorders, relationship and divorce issues, dissociative disorders, and childhood abuse issues. My primary goals include helping people deepen their understanding of themselves and their current difficulties, identify problematic patterns in their lives, and work through old hurts within a safe, understanding therapeutic relationship. I have given several talks to parents in the metro Detroit area preparing for and parenting their adolescent children.
My private practice includes work with adults, adolescents and couples, with a specialty in adolescence and young adulthood. I have particular experience in treating depression, eating disorders, relationship and divorce issues, dissociative disorders, and childhood abuse issues. My primary goals include helping people deepen their understanding of themselves and their current difficulties, identify problematic patterns in their lives, and work through old hurts within a safe, understanding therapeutic relationship. I have given several talks to parents in the metro Detroit area preparing for and parenting their adolescent children.
(586) 646-4651 View (586) 646-4651
Photo of Christopher Jon Lecznar, Licensed Professional Counselor in Saint Clair Shores, MI
Christopher Jon Lecznar
Licensed Professional Counselor, MA , LPC, NCC
Verified Verified
Saint Clair Shores, MI 48082
My goal is to help you thrive and grow by assisting you in overcoming psychological and emotional distresses. I do this by building a relationship with you, empowering you to recognize your authenticity and by promoting personal growth. I am committed in helping you achieve your short and long-term goals through a professional, personal, and confidential process.
My goal is to help you thrive and grow by assisting you in overcoming psychological and emotional distresses. I do this by building a relationship with you, empowering you to recognize your authenticity and by promoting personal growth. I am committed in helping you achieve your short and long-term goals through a professional, personal, and confidential process.
(586) 238-3743 View (586) 238-3743
Photo of Christine Armada Alcantara, Clinical Social Work/Therapist in Saint Clair Shores, MI
Christine Armada Alcantara
Clinical Social Work/Therapist, LMSW, CAADC
Verified Verified
Saint Clair Shores, MI 48080
Waitlist for new clients
You deserve to feel better! Have you felt more anxious lately? Do you struggle with self doubt? Do negative statements intrude your thoughts? Are these issues preventing you from living your best life? Imagine if you could change your life by changing your thoughts? Therapy can assist you to move forward. Daily struggles, compounded by the stress brought on by the pandemic, have made life more difficult to handle. You deserve to move through these emotions and be empowered to live a life in which you will thrive.
You deserve to feel better! Have you felt more anxious lately? Do you struggle with self doubt? Do negative statements intrude your thoughts? Are these issues preventing you from living your best life? Imagine if you could change your life by changing your thoughts? Therapy can assist you to move forward. Daily struggles, compounded by the stress brought on by the pandemic, have made life more difficult to handle. You deserve to move through these emotions and be empowered to live a life in which you will thrive.
(586) 619-8646 View (586) 619-8646
Photo of Endless Possibilities Counseling Clinic, LLC, Counselor in Saint Clair Shores, MI
Endless Possibilities Counseling Clinic, LLC
Counselor, LPC
Verified Verified
1 Endorsed
Saint Clair Shores, MI 48080
My name is Tracee L. Jackson and I am a Licensed Professional Counselor. I hold a Master of Science Degree in Mental Health Counseling and have several years of experience in the mental health field. I currently have openings for clients experiencing symptoms related to, anxiety, depression, acute or chronic stress and domestic violence. I am very passionate about my service delivery and I'm very adamant about meeting people where they are, allowing them to drive their own treatment.
My name is Tracee L. Jackson and I am a Licensed Professional Counselor. I hold a Master of Science Degree in Mental Health Counseling and have several years of experience in the mental health field. I currently have openings for clients experiencing symptoms related to, anxiety, depression, acute or chronic stress and domestic violence. I am very passionate about my service delivery and I'm very adamant about meeting people where they are, allowing them to drive their own treatment.
(586) 576-9470 View (586) 576-9470

See more therapy options for Saint Clair Shores

How does your Therapist compare?

Number of Therapists in Saint Clair Shores, MI

100+

Average cost per session

$130

Therapists in Saint Clair Shores, MI who prioritize treating:

94% Anxiety
89% Depression
73% Trauma and PTSD
71% Grief
68% Self Esteem
64% Relationship Issues
63% Coping Skills

Average years in practice

12 Years

Top 3 insurances accepted

87% BlueCross and BlueShield
55% Aetna
51% Blue Care Network

How Therapists in Saint Clair Shores, MI see their clients

81% In Person and Online
19% Online Only

Gender breakdown

82% Female
17% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Saint Clair Shores?

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.