Therapists in Mountain Lake, VA

Photo of Michael Orndoff, Clinical Social Work/Therapist, LCSW
Michael Orndoff
Clinical Social Work/Therapist, LCSW
Verified Verified
Serves Area
I am Michael Orndoff, a Licensed Clinical Social Worker (LCSW) with over 4 years of experience in the field of Social Work. I am passionate about helping adults, adolescents, and couples manage their unique challenges in daily life. I specialize in relationship issues, depression, career concerns, anger management, building self-esteem, and parenting concerns. I completed my Master's Degree in Social Work from Norfolk State University and my Bachelor's degree in Social Work from Virginia Wesleyan University.
I am Michael Orndoff, a Licensed Clinical Social Worker (LCSW) with over 4 years of experience in the field of Social Work. I am passionate about helping adults, adolescents, and couples manage their unique challenges in daily life. I specialize in relationship issues, depression, career concerns, anger management, building self-esteem, and parenting concerns. I completed my Master's Degree in Social Work from Norfolk State University and my Bachelor's degree in Social Work from Virginia Wesleyan University.
(540) 517-6020 View (540) 517-6020
Photo of Sarah Rash, Licensed Professional Counselor, LPC
Sarah Rash
Licensed Professional Counselor, LPC
Verified Verified
Serves Area
I am Sarah Rash, a Licensed Professional Counselor (LPC) with 7 years of combined experience working in a variety of counseling venues. I have a passion for helping adults understand and navigate the challenges they face as a result of life circumstances or diagnoses to lead to more rewarding day-to-day lives. I specialize in anxiety, depression, grief, coping skills education, self-esteem, some trauma work, and self-exploration/growth.
I am Sarah Rash, a Licensed Professional Counselor (LPC) with 7 years of combined experience working in a variety of counseling venues. I have a passion for helping adults understand and navigate the challenges they face as a result of life circumstances or diagnoses to lead to more rewarding day-to-day lives. I specialize in anxiety, depression, grief, coping skills education, self-esteem, some trauma work, and self-exploration/growth.
(540) 307-2453 View (540) 307-2453
Photo of Renee Anderson, Licensed Professional Counselor, LPC
Renee Anderson
Licensed Professional Counselor, LPC
Verified Verified
Serves Area
I, Renee Anderson, am a Licensed Professional Counselor (LPC) with over 25 years of experience in the mental health field. I am purposeful and passionate about helping individuals at all life stages address and conquer challenges. I specialize in treating depression, anxiety, grief, trauma, motivational issues, and the fallout caused by major life transitions. I spent 15 years in a hospital setting performing emergency evaluations, case management, and social work interventions.
I, Renee Anderson, am a Licensed Professional Counselor (LPC) with over 25 years of experience in the mental health field. I am purposeful and passionate about helping individuals at all life stages address and conquer challenges. I specialize in treating depression, anxiety, grief, trauma, motivational issues, and the fallout caused by major life transitions. I spent 15 years in a hospital setting performing emergency evaluations, case management, and social work interventions.
(540) 299-2576 View (540) 299-2576
Photo of Ashley Hallman, Licensed Professional Counselor, LPC
Ashley Hallman
Licensed Professional Counselor, LPC
Verified Verified
Online Only
I’m Ashley, a Licensed Professional Counselor focused on helping adults rewrite the narratives they've accumulated throughout life. With 9 years of diverse mental health experience, I specialize in anxiety, depression, trauma, couples, and attachment-related issues. Beyond my professional role, I’m a devoted mother and wife, well-acquainted with life’s curveballs. I offer a supportive environment that fosters self-understanding, guiding my clients toward deeper insights and growth.
I’m Ashley, a Licensed Professional Counselor focused on helping adults rewrite the narratives they've accumulated throughout life. With 9 years of diverse mental health experience, I specialize in anxiety, depression, trauma, couples, and attachment-related issues. Beyond my professional role, I’m a devoted mother and wife, well-acquainted with life’s curveballs. I offer a supportive environment that fosters self-understanding, guiding my clients toward deeper insights and growth.
(540) 616-3220 View (540) 616-3220

More Therapists Nearby

Photo of Mia Mickenberg, Licensed Professional Counselor, LPC
Mia Mickenberg
Licensed Professional Counselor, LPC
Verified Verified
Online Only
I am a Licensed Professional Counselor (LPC) with 10 years of experience in the mental health field, working with diverse populations and a wide range of issues in various settings, including schools, homes, a college counseling center, and a substance abuse prevention center. I enjoy working with youth, adolescents, and adults, and I use a holistic and integrative approach to counseling because, as individuals, we are not just our minds or physical selves but a blend of both.
I am a Licensed Professional Counselor (LPC) with 10 years of experience in the mental health field, working with diverse populations and a wide range of issues in various settings, including schools, homes, a college counseling center, and a substance abuse prevention center. I enjoy working with youth, adolescents, and adults, and I use a holistic and integrative approach to counseling because, as individuals, we are not just our minds or physical selves but a blend of both.
(540) 924-1964 View (540) 924-1964
Photo of Amanda Kassay, Licensed Professional Counselor, LPC
Amanda Kassay
Licensed Professional Counselor, LPC
Verified Verified
Blacksburg, VA 24060
I am a Licensed Professional Counselor (LPC) in Virginia with over six years of experience, working with individuals from childhood through late adulthood in both individual and family therapeutic settings. I partner with clients to help them work through and manage challenges such as anxiety, depression, trauma, self-esteem issues, stress, life transitions, grief, and loss. I received my Master’s degree in Counseling and Human Services in 2015 from the CACREP-accredited Lindsey Wilson College, School of Professional Counseling in Columbia, KY.
I am a Licensed Professional Counselor (LPC) in Virginia with over six years of experience, working with individuals from childhood through late adulthood in both individual and family therapeutic settings. I partner with clients to help them work through and manage challenges such as anxiety, depression, trauma, self-esteem issues, stress, life transitions, grief, and loss. I received my Master’s degree in Counseling and Human Services in 2015 from the CACREP-accredited Lindsey Wilson College, School of Professional Counseling in Columbia, KY.
(540) 572-7109 View (540) 572-7109
Photo of Theresa Aileen Shuart, Marriage & Family Therapist, LPC, LMFT
Theresa Aileen Shuart
Marriage & Family Therapist, LPC, LMFT
Verified Verified
2 Endorsed
Rich Creek, VA 24147
Ms. Theresa Shuart is a Clinical Fellow in the American Association of Marriage and Family Therapists with more than 35 years’ experience working with patients in the mental health field, helping people of all ages (age 3 and above), and she specializes in marriage and family therapy and loves working with children. Her clientele is diverse; she works with individuals, couples, and families. Typical treatment issues include anxiety, depression, behavioral problems; blended families; marriage issues, and military family issues.
Ms. Theresa Shuart is a Clinical Fellow in the American Association of Marriage and Family Therapists with more than 35 years’ experience working with patients in the mental health field, helping people of all ages (age 3 and above), and she specializes in marriage and family therapy and loves working with children. Her clientele is diverse; she works with individuals, couples, and families. Typical treatment issues include anxiety, depression, behavioral problems; blended families; marriage issues, and military family issues.
(703) 991-0519 View (703) 991-0519
Photo of Ramona Wilson, Pre-Licensed Professional, Residen
Ramona Wilson
Pre-Licensed Professional, Residen
Verified Verified
Online Only
I am a Supervisee in Social Work with over 10 years of experience in the human services field. I focus on supporting adults and families dealing with anxiety, depression, grief, and life transitions. My background includes crisis intervention, mental health assessments, and utilizing evidence-based therapeutic approaches tailored to the unique needs of my clients. I am dedicated to helping clients build resilience, achieve their goals, and uncover their inner strengths.
I am a Supervisee in Social Work with over 10 years of experience in the human services field. I focus on supporting adults and families dealing with anxiety, depression, grief, and life transitions. My background includes crisis intervention, mental health assessments, and utilizing evidence-based therapeutic approaches tailored to the unique needs of my clients. I am dedicated to helping clients build resilience, achieve their goals, and uncover their inner strengths.
(540) 386-1863 View (540) 386-1863
Photo of Kilexyus Moore, Supervisee in Clinical Social Work, MSSW
Kilexyus Moore
Supervisee in Clinical Social Work, MSSW
Verified Verified
1 Endorsed
Online Only
I am a Supervisee in Social Work under Tierra Hereford. I offer tele-health services in Virginia and DC. You will find that I provide a judgement free space where you can be honest about the struggles that have led you to therapy. I help support clients in reaching their goals, increasing their understanding of themselves and others, and healing by providing a supportive, safe, and warm therapeutic environment. I specialize in helping patients work through challenges with trauma/PTSD diagnosis, LGBTQ+ population, and grief & loss. I also provide therapy for other issues such as depression and anxiety.
I am a Supervisee in Social Work under Tierra Hereford. I offer tele-health services in Virginia and DC. You will find that I provide a judgement free space where you can be honest about the struggles that have led you to therapy. I help support clients in reaching their goals, increasing their understanding of themselves and others, and healing by providing a supportive, safe, and warm therapeutic environment. I specialize in helping patients work through challenges with trauma/PTSD diagnosis, LGBTQ+ population, and grief & loss. I also provide therapy for other issues such as depression and anxiety.
(571) 200-4760 View (571) 200-4760
Photo of Avrial Mendoza - Abundant Life Christian Counseling, Licensed Professional Counselor, LPC
Abundant Life Christian Counseling
Licensed Professional Counselor, LPC
Verified Verified
Ripplemead, VA 24150
Do you need a better way to cope with anxiety or depression? You may need help finding practical strategies & skills to help you not only get through your day, but improve your ability to navigate school or work, relational, and spiritual challenges. You may need a safe place to talk about your beliefs or doubts. Maybe life has changed, and you can't seem to adjust. Maybe it all has become too much, & self-worth, health, and things that were once so important have taken a hit. You would like to feel happy and hopeful again. Or at least have some tools so that you feel a sense of positive progress and growth.
Do you need a better way to cope with anxiety or depression? You may need help finding practical strategies & skills to help you not only get through your day, but improve your ability to navigate school or work, relational, and spiritual challenges. You may need a safe place to talk about your beliefs or doubts. Maybe life has changed, and you can't seem to adjust. Maybe it all has become too much, & self-worth, health, and things that were once so important have taken a hit. You would like to feel happy and hopeful again. Or at least have some tools so that you feel a sense of positive progress and growth.
(540) 227-0005 View (540) 227-0005
Photo of Connie Fisher Hopkins, Clinical Social Work/Therapist, LCSW
Connie Fisher Hopkins
Clinical Social Work/Therapist, LCSW
Verified Verified
Christiansburg, VA 24073
I am a graduate from Radford University earning a Bachelors Degree with a focus on social work. I received a Masters of Social Work from Radford in 2014 and began working toward being a LCSW. I received my LCSW in 2017 and have been working in outpatient therapy since. I have experience with anxiety disorders, depressive disorders, bipolar disorder, ADD/ADHD, oppositional defiant disorder, anger management, parenting issues, personality disorders, trauma, and grief. I work from a strength-based perspective with a client-centered style.
I am a graduate from Radford University earning a Bachelors Degree with a focus on social work. I received a Masters of Social Work from Radford in 2014 and began working toward being a LCSW. I received my LCSW in 2017 and have been working in outpatient therapy since. I have experience with anxiety disorders, depressive disorders, bipolar disorder, ADD/ADHD, oppositional defiant disorder, anger management, parenting issues, personality disorders, trauma, and grief. I work from a strength-based perspective with a client-centered style.
(540) 307-2972 View (540) 307-2972
Photo of Amanda Hardwick, Clinical Social Work/Therapist, LCSW, RPT, CACYFSW
Amanda Hardwick
Clinical Social Work/Therapist, LCSW, RPT, CACYFSW
Verified Verified
Christiansburg, VA 24073
Not accepting new clients
I love working with individuals and families and have been for 8 years in the New River Valley in a wide variety of roles. My approach is tailored for each client, situation and goal to find what works best for each unique individual. I use an eclectic approach and embrace a person-centered philosophy to best meet my client's needs and take joy in helping others explore and achieve personal goals to live a healthier and happier life.
I love working with individuals and families and have been for 8 years in the New River Valley in a wide variety of roles. My approach is tailored for each client, situation and goal to find what works best for each unique individual. I use an eclectic approach and embrace a person-centered philosophy to best meet my client's needs and take joy in helping others explore and achieve personal goals to live a healthier and happier life.
(540) 469-5147 View (540) 469-5147
Donna Wagner
Licensed Professional Counselor, LPC
Verified Verified
Christiansburg, VA 24073
Waitlist for new clients
Donna believes in increasing personal strengths and resilience through a person-centered and creative approach to therapy. She is passionate about helping clients achieve their desired therapy goals. Donna is a Licensed Professional Counselor. She graduated with a degree in Counselor Education from Radford University in 2011. Donna has over 10 years of experience providing counseling to children, adolescents and their families. She has a background in outpatient counseling and crisis counseling services.
Donna believes in increasing personal strengths and resilience through a person-centered and creative approach to therapy. She is passionate about helping clients achieve their desired therapy goals. Donna is a Licensed Professional Counselor. She graduated with a degree in Counselor Education from Radford University in 2011. Donna has over 10 years of experience providing counseling to children, adolescents and their families. She has a background in outpatient counseling and crisis counseling services.
(540) 680-3015 View (540) 680-3015
Photo of Wendy Eckenrod-Green, Pre-Licensed Professional, PhD, NCC
Wendy Eckenrod-Green
Pre-Licensed Professional, PhD, NCC
Verified Verified
Christiansburg, VA 24073
As a counselor, I believe that vulnerability is the cornerstone of true healing and growth. It is through embracing vulnerability that individuals begin to unlock their fullest potential and lead a more authentic, fulfilled life. My approach centers around creating a safe and compassionate environment where clients can explore their emotions, confront their fears, and ultimately discover the courage to live their best life. Through our work together, I hope to instill in each client the understanding that they deserve to live fully and authentically.
As a counselor, I believe that vulnerability is the cornerstone of true healing and growth. It is through embracing vulnerability that individuals begin to unlock their fullest potential and lead a more authentic, fulfilled life. My approach centers around creating a safe and compassionate environment where clients can explore their emotions, confront their fears, and ultimately discover the courage to live their best life. Through our work together, I hope to instill in each client the understanding that they deserve to live fully and authentically.
(540) 712-8500 View (540) 712-8500
Photo of Paul Delaughter, Licensed Professional Counselor, MAEd
Paul Delaughter
Licensed Professional Counselor, MAEd
Verified Verified
1 Endorsed
Online Only
Not accepting new clients
Paul Delaughter is a Licensed Professional Counselor who is passionate about helping others address the challenges in their lives. Paul implements an evidence-based approach toward helping his clients identify and address the challenges they face.
Paul Delaughter is a Licensed Professional Counselor who is passionate about helping others address the challenges in their lives. Paul implements an evidence-based approach toward helping his clients identify and address the challenges they face.
(540) 889-0745 View (540) 889-0745
Photo of John Leonard, Licensed Professional Counselor, LPC
John Leonard
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Blacksburg, VA 24060
We each have our own unique journey through life. We are constantly growing, changing, and developing. Sometimes we need help facing obstacles that block our progress or threaten our wellbeing. I want to help you identify those roadblocks and guide you over, around, or through them. My goal is to see your life from your perspective so I can accompany you in exploring who you are, where you have been, and who you want to become. Growth can be tough - we don't grow when we're comfortable - but you don’t have to face these changes alone. Together, we can develop clarity, confidence, and insight to help you achieve a better life.
We each have our own unique journey through life. We are constantly growing, changing, and developing. Sometimes we need help facing obstacles that block our progress or threaten our wellbeing. I want to help you identify those roadblocks and guide you over, around, or through them. My goal is to see your life from your perspective so I can accompany you in exploring who you are, where you have been, and who you want to become. Growth can be tough - we don't grow when we're comfortable - but you don’t have to face these changes alone. Together, we can develop clarity, confidence, and insight to help you achieve a better life.
(540) 402-9961 View (540) 402-9961
Photo of Emily Webb Olsen - Big Oak Wellness, Licensed Professional Counselor, LPC, LCMHC, RYT200
Big Oak Wellness
Licensed Professional Counselor, LPC, LCMHC, RYT200
Verified Verified
1 Endorsed
Blacksburg, VA 24061
If you’ve tried therapy before and feel stuck or disconnected, or if you’ve been facing unresolved trauma from childhood, you’re in the right place. Our clinic is especially beneficial for individuals navigating difficult life transitions, such as new parents confronting childhood wounds or anyone struggling with the effects of generational trauma. We understand that healing isn't just about talking through your experiences—it’s about connecting the mind and body. Many of the emotional challenges we face are stored in our bodies, often leading to feelings of being overwhelmed or disconnected.
If you’ve tried therapy before and feel stuck or disconnected, or if you’ve been facing unresolved trauma from childhood, you’re in the right place. Our clinic is especially beneficial for individuals navigating difficult life transitions, such as new parents confronting childhood wounds or anyone struggling with the effects of generational trauma. We understand that healing isn't just about talking through your experiences—it’s about connecting the mind and body. Many of the emotional challenges we face are stored in our bodies, often leading to feelings of being overwhelmed or disconnected.
(540) 592-4778 View (540) 592-4778
Photo of Amber Jean Eversole - Amber Eversole, LPC, PLLC, Licensed Professional Counselor, MA, LPC
Amber Eversole, LPC, PLLC
Licensed Professional Counselor, MA, LPC
Verified Verified
2 Endorsed
Blacksburg, VA 24060
I am honored to be able to work with individuals and couples and to be a part of their journey towards living a better life. I believe that everyone is doing the best they can and they are also able to do better given new perspectives and skills. I have experience working with young adults, adults, and couples. I believe it is difficult for many to take the first step and reach out for help. I strive to provide a welcoming and nonjudgmental environment in which you feel comfortable to discuss your story and to build an effective therapeutic relationship.
I am honored to be able to work with individuals and couples and to be a part of their journey towards living a better life. I believe that everyone is doing the best they can and they are also able to do better given new perspectives and skills. I have experience working with young adults, adults, and couples. I believe it is difficult for many to take the first step and reach out for help. I strive to provide a welcoming and nonjudgmental environment in which you feel comfortable to discuss your story and to build an effective therapeutic relationship.
(980) 222-0104 View (980) 222-0104
Photo of Erin Shaffer, Clinical Social Work/Therapist, LCSW
Erin Shaffer
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Dublin, VA 24084
I am so glad you are taking the steps to find support and take care of yourself! It can be difficult to reach out and ask for support and it is important to find a safe and compassionate space to be able to process trauma, grief, or general stress. As a Licensed Clinical Social Worker, I enjoy helping individuals build on their strengths to find healing. I will work with you to develop treatment goals and offer support as you work towards those goals. I offer both in person and telehealth appointments.
I am so glad you are taking the steps to find support and take care of yourself! It can be difficult to reach out and ask for support and it is important to find a safe and compassionate space to be able to process trauma, grief, or general stress. As a Licensed Clinical Social Worker, I enjoy helping individuals build on their strengths to find healing. I will work with you to develop treatment goals and offer support as you work towards those goals. I offer both in person and telehealth appointments.
(540) 306-4218 View (540) 306-4218
Photo of Monica Swann, Pre-Licensed Professional, MA
Monica Swann
Pre-Licensed Professional, MA
Verified Verified
1 Endorsed
Christiansburg, VA 24073
There are times in our journey where we stop and ask ourselves, “how did I get here?”. As people, we are constantly exploring our growth edges and trying to adapt to the challenges and changes in our lives. Navigating those changes on our own may be frustrating, scary and sometimes leave us feeling unclear and hopeless. No matter where in life you are currently, there is power in asking for help. I want to walk with you to safely explore the past, learn to stay mindful in the present, and work to improve your future. Sometimes the most challenging pieces of our story simply need to be acknowledged before they can be understood.
There are times in our journey where we stop and ask ourselves, “how did I get here?”. As people, we are constantly exploring our growth edges and trying to adapt to the challenges and changes in our lives. Navigating those changes on our own may be frustrating, scary and sometimes leave us feeling unclear and hopeless. No matter where in life you are currently, there is power in asking for help. I want to walk with you to safely explore the past, learn to stay mindful in the present, and work to improve your future. Sometimes the most challenging pieces of our story simply need to be acknowledged before they can be understood.
(276) 409-8671 View (276) 409-8671

See more therapy options for Mountain Lake

How does your Therapist compare?

Number of Therapists in Mountain Lake, VA

< 10

Therapists in Mountain Lake, VA who prioritize treating:

100% Depression
100% Coping Skills
100% Stress
75% Anxiety
75% Grief
75% Anger Management
75% Self Esteem

Average years in practice

9 Years

Top 3 insurances accepted

100% Aetna
100% BlueCross and BlueShield
100% Cigna and Evernorth

How Therapists in Mountain Lake, VA see their clients

75% In Person and Online
25% Online Only

Gender breakdown

75% Female
25% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Mountain Lake?

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.