Therapists in Zion Crossroads, VA

Photo of Karen Cersley, Licensed Professional Counselor in Zion Crossroads, VA
Karen Cersley
Licensed Professional Counselor, LPC, MBA, MA
Verified Verified
2 Endorsed
Zion Crossroads, VA 22942
Waitlist for new clients
Are you looking for more fulfillment in life, more happiness, and more tools for self-discovery, relationship-building, and problem-solving? Through our collaboration, we will identify and set specific goals and then work together to make meaningful changes. Through a spiritual psychology approach, we will partner together to help you maintain physical, emotional, mental, and spiritual health & well-being. If you are willing to invest yourself in the process, I will walk beside you on your journey to reach your goals and dreams while you learn more effectively how to deal with situations in your life. How can I serve you?
Are you looking for more fulfillment in life, more happiness, and more tools for self-discovery, relationship-building, and problem-solving? Through our collaboration, we will identify and set specific goals and then work together to make meaningful changes. Through a spiritual psychology approach, we will partner together to help you maintain physical, emotional, mental, and spiritual health & well-being. If you are willing to invest yourself in the process, I will walk beside you on your journey to reach your goals and dreams while you learn more effectively how to deal with situations in your life. How can I serve you?
(434) 473-7243 View (434) 473-7243
Photo of Barbara J Blair, Licensed Professional Counselor in Zion Crossroads, VA
Barbara J Blair
Licensed Professional Counselor, LPC
Verified Verified
Zion Crossroads, VA 22942
Life is hard, we all struggle from time to time and just need someone to talk to about our feelings and struggles. Perhaps you have unresolved trauma or lost a loved one, or dealing with increased anxiety in this ever changing and uncertain world we are living in. If this sounds like you, please let me help. I will listen with compassion, help you identify areas in your life that are too difficult to handle on your own, help you identify healthy coping skills to manage anxiety, depression, and difficulty concentrating. Call today to see if I'm the right fit for you.
Life is hard, we all struggle from time to time and just need someone to talk to about our feelings and struggles. Perhaps you have unresolved trauma or lost a loved one, or dealing with increased anxiety in this ever changing and uncertain world we are living in. If this sounds like you, please let me help. I will listen with compassion, help you identify areas in your life that are too difficult to handle on your own, help you identify healthy coping skills to manage anxiety, depression, and difficulty concentrating. Call today to see if I'm the right fit for you.
(434) 363-9437 View (434) 363-9437
Photo of Jessica Campos, Clinical Social Work/Therapist in Zion Crossroads, VA
Jessica Campos
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Zion Crossroads, VA 22942
I have worked in the field as a mental health provider for at-risk and vulnerable populations since 2006. I am certified in Trauma and Resilience and also have a minor in special education.
I have worked in the field as a mental health provider for at-risk and vulnerable populations since 2006. I am certified in Trauma and Resilience and also have a minor in special education.
(434) 331-1023 View (434) 331-1023
Photo of Devin Byam, Licensed Professional Counselor in Zion Crossroads, VA
Devin Byam
Licensed Professional Counselor, LPC
Verified Verified
2 Endorsed
Zion Crossroads, VA 22942
I am passionate about working with individuals, couples and families in order to create healthy and sustainable thoughts, feelings, and patterns of behavior that empower them to be their best selves. My ideal client is someone who is motivated to change and recognizes that, even in life's hard times, you can still make positive changes that will empower you to move forward.
I am passionate about working with individuals, couples and families in order to create healthy and sustainable thoughts, feelings, and patterns of behavior that empower them to be their best selves. My ideal client is someone who is motivated to change and recognizes that, even in life's hard times, you can still make positive changes that will empower you to move forward.
(434) 277-2061 View (434) 277-2061

More Therapists Nearby

Photo of Kim B Dew, Licensed Professional Counselor in Zion Crossroads, VA
Kim B Dew
Licensed Professional Counselor, MS, LPC
Verified Verified
Barboursville, VA 22923
Waitlist for new clients
Life can be challenging, overwhelming and confusing at times, whether you are an adult, adolescent or child. I work to help clients and their families define these emotions, recognize the control they have and build their strengths to shape new, healthy coping skills .I specialize in working with anxiety and mood disorders and have worked extensively during the past 25 years with families, children and adolescents to help them find answers that are right for them. Additionally, I have experience working with adults and children who have suffered PTSD or trauma, using a cognitive-behavioral approach with proven mind/body techniques.
Life can be challenging, overwhelming and confusing at times, whether you are an adult, adolescent or child. I work to help clients and their families define these emotions, recognize the control they have and build their strengths to shape new, healthy coping skills .I specialize in working with anxiety and mood disorders and have worked extensively during the past 25 years with families, children and adolescents to help them find answers that are right for them. Additionally, I have experience working with adults and children who have suffered PTSD or trauma, using a cognitive-behavioral approach with proven mind/body techniques.
(540) 318-1652 View (540) 318-1652
Photo of Sara Ann Miller, Clinical Social Work/Therapist in Zion Crossroads, VA
Sara Ann Miller
Clinical Social Work/Therapist, LCSW
Verified Verified
Gordonsville, VA 22942
Do you want to increase your happiness? My life’s work has been researching ways to overcome challenges and change and sharing those modalities with others. University of Pennsylvania traditionally trained. Trauma Specialization. 25 year Child Welfare Public Servant.
Do you want to increase your happiness? My life’s work has been researching ways to overcome challenges and change and sharing those modalities with others. University of Pennsylvania traditionally trained. Trauma Specialization. 25 year Child Welfare Public Servant.
(833) 415-0716 View (833) 415-0716
Photo of Heather Dumas, Licensed Professional Counselor in Zion Crossroads, VA
Heather Dumas
Licensed Professional Counselor, M Ed, LPC
Verified Verified
Gordonsville, VA 22942
Are you struggling to manage your emotions or behavior? I can help you learn how to better regulate your emotions so that you can feel better and have healthier relationships. I offer in person sessions in Stanardsville, as well as teletherapy sessions. My schedule allows me to offer evening and weekend appointments, so you won’t need to miss work.
Are you struggling to manage your emotions or behavior? I can help you learn how to better regulate your emotions so that you can feel better and have healthier relationships. I offer in person sessions in Stanardsville, as well as teletherapy sessions. My schedule allows me to offer evening and weekend appointments, so you won’t need to miss work.
(434) 216-3421 View (434) 216-3421
Photo of Hannah Pocock, Clinical Social Work/Therapist in Zion Crossroads, VA
Hannah Pocock
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Barboursville, VA 22923
I offer individual therapy for adults and adolescents, and specialize in working with women and teens dealing with the impact of sexual assault, childhood abuse, or other trauma. Other areas of clinical interest include relationship issues, life transitions, anxiety, and identity questions. I believe therapy is a collaborative process that allows us to be deeply seen and heard, and to see ourselves in new and transformative ways. It can build self-esteem and strengthen our sense of who we are and how we fit into the world. As we understand ourselves more fully, relationships with others become richer and more fulfilling. Therapy can strengthen our ability to adapt and adjust to the changing circumstances of our lives, freeing us up to respond more flexibly to the world around us and to experience a more enlivened way of being. For trauma survivors who experience overwhelming waves of shame and fear, a lurking sense of unease, or confusing physical sensations, therapy can help calm the mind and the nervous system, allowing you to move from reliving the past to feeling grounded, present, and whole in mind and body.
I offer individual therapy for adults and adolescents, and specialize in working with women and teens dealing with the impact of sexual assault, childhood abuse, or other trauma. Other areas of clinical interest include relationship issues, life transitions, anxiety, and identity questions. I believe therapy is a collaborative process that allows us to be deeply seen and heard, and to see ourselves in new and transformative ways. It can build self-esteem and strengthen our sense of who we are and how we fit into the world. As we understand ourselves more fully, relationships with others become richer and more fulfilling. Therapy can strengthen our ability to adapt and adjust to the changing circumstances of our lives, freeing us up to respond more flexibly to the world around us and to experience a more enlivened way of being. For trauma survivors who experience overwhelming waves of shame and fear, a lurking sense of unease, or confusing physical sensations, therapy can help calm the mind and the nervous system, allowing you to move from reliving the past to feeling grounded, present, and whole in mind and body.
(434) 248-3836 View (434) 248-3836
Photo of Monarch Journey Counseling Services LLC, Licensed Professional Counselor in Zion Crossroads, VA
Monarch Journey Counseling Services LLC
Licensed Professional Counselor, LPC, COSTP, RPT-S, CSAC, ACS
Verified Verified
2 Endorsed
Orange, VA 22960
Monarch Journey Counseling LLC is moving to Madison Aug. 21, 2023. The new address is 1287 N S Seminole Trail Madison, Virginia 22727. We look forward to seeing you there!
Monarch Journey Counseling LLC is moving to Madison Aug. 21, 2023. The new address is 1287 N S Seminole Trail Madison, Virginia 22727. We look forward to seeing you there!
(540) 406-7658 View (540) 406-7658
Photo of Courtney D Bonilla, Licensed Professional Counselor in Zion Crossroads, VA
Courtney D Bonilla
Licensed Professional Counselor, LPC
Verified Verified
Troy, VA 22974
I believe the therapeutic relationship is a collaborative one in which you have the power to make lasting changes toward a more balanced, connected and resourced life. I am a Licensed Professional Counselor providing individual and family counseling to children, adolescents, families and adults. I have extensive knowledge of behavior management strategies and parenting skill support as a former provider of Therapeutic Day Treatment in the school setting and Intensive In-home Services.  My training in trauma and resilience informs my work and allows for the strengths of the individual to guide growth and healing.
I believe the therapeutic relationship is a collaborative one in which you have the power to make lasting changes toward a more balanced, connected and resourced life. I am a Licensed Professional Counselor providing individual and family counseling to children, adolescents, families and adults. I have extensive knowledge of behavior management strategies and parenting skill support as a former provider of Therapeutic Day Treatment in the school setting and Intensive In-home Services.  My training in trauma and resilience informs my work and allows for the strengths of the individual to guide growth and healing.
(434) 208-2615 View (434) 208-2615
Photo of Rachel Salinas, Licensed Professional Counselor in Zion Crossroads, VA
Rachel Salinas
Licensed Professional Counselor, LPC
Verified Verified
Trevilians, VA 23170
Rachel Salinas is a Licensed Professional Counselor (LPC) with 5 years of experience providing psychotherapy to adults, both young and old. She works with clients experiencing a range of mental health issues, including depression, anxiety, trauma, grief, chronic health conditions, and relationship problems. Rachel enjoys getting to know each unique individual and supporting them in developing a roadmap to achieve their goals and find more satisfaction in their lives.
Rachel Salinas is a Licensed Professional Counselor (LPC) with 5 years of experience providing psychotherapy to adults, both young and old. She works with clients experiencing a range of mental health issues, including depression, anxiety, trauma, grief, chronic health conditions, and relationship problems. Rachel enjoys getting to know each unique individual and supporting them in developing a roadmap to achieve their goals and find more satisfaction in their lives.
(804) 373-8446 View (804) 373-8446
Photo of Shannon Stewart Enold, Clinical Social Work/Therapist in Zion Crossroads, VA
Shannon Stewart Enold
Clinical Social Work/Therapist
Verified Verified
Keswick, VA 22947  (Online Only)
I enjoy working with anyone who wants to improve their well-being & overall happiness. Sometimes we are inspired to improve our lives & wish to set goals to accomplish. Other times, life brings unexpected changes that can be overwhelming. I have extensive experience working with couples, military families, oncology & hospice. Survivorship & caregiver fatigue are also near & dear to me.
I enjoy working with anyone who wants to improve their well-being & overall happiness. Sometimes we are inspired to improve our lives & wish to set goals to accomplish. Other times, life brings unexpected changes that can be overwhelming. I have extensive experience working with couples, military families, oncology & hospice. Survivorship & caregiver fatigue are also near & dear to me.
(540) 264-3414 View (540) 264-3414
Photo of Dr. Brenda L Ridgeway Professional Psychologist in Zion Crossroads, VA
Dr. Brenda L Ridgeway Professional Psychologist
PhD/, LSATP, CCDVC, HS-BCP
Verified Verified
Louisa, VA 23093  (Online Only)
My belief is that healing is possible and that all of us have the answers and solutions to troubling personal questions and stressful circumstances in our lives, but sometimes we all need a bit of support and guidance to find those answers. Recovery is an amazing and sacred journey, one that leads to self-healing, self-fulfillment, and happiness. I am a Licensed Substance Abuse Treatment Practitioner specializing in working with those seeking a better physical and emotional life and overall well-being. I use empirically sound evidenced-based interventions to assist with your healing process.
My belief is that healing is possible and that all of us have the answers and solutions to troubling personal questions and stressful circumstances in our lives, but sometimes we all need a bit of support and guidance to find those answers. Recovery is an amazing and sacred journey, one that leads to self-healing, self-fulfillment, and happiness. I am a Licensed Substance Abuse Treatment Practitioner specializing in working with those seeking a better physical and emotional life and overall well-being. I use empirically sound evidenced-based interventions to assist with your healing process.
(540) 274-0635 View (540) 274-0635

Online Therapists

Photo of Life Way Services, LLC in Zion Crossroads, VA
Life Way Services, LLC
MDiv
Verified Verified
4 Endorsed
Ruther Glen, VA 22546
Life Way Services are the "go-the-extra-mile" team that will walk with you and encourage you the entire way to wholeness. Our mission is to provide youth and adults with compassionate mental and emotional health services that will aid clients in their transition towards wholeness through preventative, interventions, and educational practices.
Life Way Services are the "go-the-extra-mile" team that will walk with you and encourage you the entire way to wholeness. Our mission is to provide youth and adults with compassionate mental and emotional health services that will aid clients in their transition towards wholeness through preventative, interventions, and educational practices.
(804) 373-2705 View (804) 373-2705
Photo of LeRoy Hughes, Pre-Licensed Professional in Zion Crossroads, VA
LeRoy Hughes
Pre-Licensed Professional
Verified Verified
Woodbridge, VA 22192
I am Mr. LeRoy Hughes and I am a Resident in Counseling in the Commonwealth of VA. With extensive background in education and mental health, I have experience working in multiple clinical settings including Intensive In-Home Programs and Private Practice serving populations including children, adolescents & adults. I have experience working with both mental health symptomology and Intellectual Disabilities. My objective is to provide clients with a safe and non-judgmental space for absolute healing. I guide clients on a transformative journey, helping them recognize that the answers to life's challenges lie within themselves.
I am Mr. LeRoy Hughes and I am a Resident in Counseling in the Commonwealth of VA. With extensive background in education and mental health, I have experience working in multiple clinical settings including Intensive In-Home Programs and Private Practice serving populations including children, adolescents & adults. I have experience working with both mental health symptomology and Intellectual Disabilities. My objective is to provide clients with a safe and non-judgmental space for absolute healing. I guide clients on a transformative journey, helping them recognize that the answers to life's challenges lie within themselves.
(571) 380-7815 View (571) 380-7815
Photo of Anna Carpenter, Pre-Licensed Professional in Zion Crossroads, VA
Anna Carpenter
Pre-Licensed Professional, MA, MEd
Verified Verified
1 Endorsed
Williamsburg, VA 23188  (Online Only)
Greetings from Thailand, where my family is posted with the State Dep’t. My hours are in Virginia’s evenings and all throughout the day for those in other countries. I specialize in working with individuals, 18+ in the gov’t-connected and global community; service members, veterans, State Dep’t or other 3-letter agencies most can’t talk about, first responders, missionaries, aid workers, etc., and their families. As a veteran myself, I see your lonely nights, stressful deployments, difficulty adjusting, constantly shifting community, decision fatigue, parental guilt and continual first and second-hand trauma you've endured.
Greetings from Thailand, where my family is posted with the State Dep’t. My hours are in Virginia’s evenings and all throughout the day for those in other countries. I specialize in working with individuals, 18+ in the gov’t-connected and global community; service members, veterans, State Dep’t or other 3-letter agencies most can’t talk about, first responders, missionaries, aid workers, etc., and their families. As a veteran myself, I see your lonely nights, stressful deployments, difficulty adjusting, constantly shifting community, decision fatigue, parental guilt and continual first and second-hand trauma you've endured.
(757) 704-5237 View (757) 704-5237
Photo of Mary Ann Byrne, Licensed Professional Counselor in Zion Crossroads, VA
Mary Ann Byrne
Licensed Professional Counselor, MEd, LPC, NCC
Verified Verified
2 Endorsed
Fredericksburg, VA 22401
TELEHEALTH AVAILABLE I work with children and adolescents experiencing issues with social skills, learning difficulties, Autism, depression, anxiety, divorce and oppositional behaviors. I also work with parents on how to parent a child with ODD, ADHD and Autism. Children, tweens and teens who are struggling with self-esteem, divorce, peer relations, school issues, depression or anxiety are my passion. I want to help them learn to navigate their young world more effectively and achieve their potential.
TELEHEALTH AVAILABLE I work with children and adolescents experiencing issues with social skills, learning difficulties, Autism, depression, anxiety, divorce and oppositional behaviors. I also work with parents on how to parent a child with ODD, ADHD and Autism. Children, tweens and teens who are struggling with self-esteem, divorce, peer relations, school issues, depression or anxiety are my passion. I want to help them learn to navigate their young world more effectively and achieve their potential.
(540) 698-3727 View (540) 698-3727
Photo of Jessica Hodges, Licensed Professional Counselor in Zion Crossroads, VA
Jessica Hodges
Licensed Professional Counselor, LPC
Verified Verified
Richmond, VA 23224
My name is Jessica Hodges. I am a Licensed Professional Counselor as well as a Certified Substance Abuse counselor in the state of Virginia. I practice from a person-centered modality while working with my clients to develop treatment goals. I specialize in addiction, anxiety, and emotional regulation. I am most comfortable in treating clients aged 18 and older. I believe that as long as my clients aim for improved mental health, we can work together to achieve that! I believe in open and honest communication with my clients. Full transparency with professional boundaries is essential in encouraging change.
My name is Jessica Hodges. I am a Licensed Professional Counselor as well as a Certified Substance Abuse counselor in the state of Virginia. I practice from a person-centered modality while working with my clients to develop treatment goals. I specialize in addiction, anxiety, and emotional regulation. I am most comfortable in treating clients aged 18 and older. I believe that as long as my clients aim for improved mental health, we can work together to achieve that! I believe in open and honest communication with my clients. Full transparency with professional boundaries is essential in encouraging change.
(804) 589-4095 View (804) 589-4095
Photo of Dwight Dugan, Clinical Social Work/Therapist in Zion Crossroads, VA
Dwight Dugan
Clinical Social Work/Therapist, LCSW
Verified Verified
3 Endorsed
Lexington, VA 24450
Do you want to feel more at home in your own skin? Do you wonder why you haven't already "figured things out"? Do behaviors and beliefs that once helped you survive now keep you from authentically relating with others? Does your gut tell you there is another way of being, but you just can't seem to get there? Whatever your aspiration or longing, being a person isn't easy and transformation can feel daunting. Having struggled with these questions myself, it would be my honor to accompany you on your path. My approach is informed by a therapy model called AEDP, which seeks to undo aloneness and draw upon your innate healing capacity.
Do you want to feel more at home in your own skin? Do you wonder why you haven't already "figured things out"? Do behaviors and beliefs that once helped you survive now keep you from authentically relating with others? Does your gut tell you there is another way of being, but you just can't seem to get there? Whatever your aspiration or longing, being a person isn't easy and transformation can feel daunting. Having struggled with these questions myself, it would be my honor to accompany you on your path. My approach is informed by a therapy model called AEDP, which seeks to undo aloneness and draw upon your innate healing capacity.
(512) 270-6224 View (512) 270-6224
Photo of Lauren Rivers, Licensed Professional Counselor in Zion Crossroads, VA
Lauren Rivers
Licensed Professional Counselor, MS
Verified Verified
3 Endorsed
Fairfax, VA 22030  (Online Only)
I enjoy working collaboratively alongside adults, young adults, and college-aged students, navigating interpersonal relationship concerns, time management, stress, and communication issues. I am trained to work through trauma and PTSD, OCD, anxiety, depression, adjustment concerns, family relational issues, and ADHD.
I enjoy working collaboratively alongside adults, young adults, and college-aged students, navigating interpersonal relationship concerns, time management, stress, and communication issues. I am trained to work through trauma and PTSD, OCD, anxiety, depression, adjustment concerns, family relational issues, and ADHD.
(571) 554-6460 View (571) 554-6460

How does your Therapist compare?

Number of Therapists in Zion Crossroads, VA

< 10

Therapists in Zion Crossroads, VA who prioritize treating:

100% Depression
100% Anxiety
100% Coping Skills
100% Self Esteem
100% Stress
75% Grief
75% Trauma and PTSD

Average years in practice

8 Years

Top 3 insurances accepted

100% BlueCross and BlueShield
100% Anthem | Elevance
100% Optima

How Therapists in Zion Crossroads, VA see their clients

100% In Person and Online

Gender breakdown

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

How can I find a therapist in Zion Crossroads?

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.