Therapists in Ludlow, VT

Photo of Dean Hammer, Psychologist in Ludlow, VT
Dean Hammer
Psychologist, PsyD
Verified Verified
Ludlow, VT 05149
I am very fortune to have practiced as a psychotherapist for thirty years--providing treatment to clients ranging from young adults to those in their elder years. Depending on clients' need, I provide brief term counseling as well as longer term treatment. I employ a variety of approaches in my counseling including: Narrative, Cognitive-Behavioral, Relational, and Mediation therapies.
I am very fortune to have practiced as a psychotherapist for thirty years--providing treatment to clients ranging from young adults to those in their elder years. Depending on clients' need, I provide brief term counseling as well as longer term treatment. I employ a variety of approaches in my counseling including: Narrative, Cognitive-Behavioral, Relational, and Mediation therapies.
(802) 662-2641 View (802) 662-2641
Photo of Peggy Liss, Clinical Social Work/Therapist in Ludlow, VT
Peggy Liss
Clinical Social Work/Therapist, MSW, LMSW, LMFT, BCD, DCSW
Verified Verified
Ludlow, VT 05149  (Online Only)
Together we will create a compassionate & emotionally safe space for you to explore how you became the YOU that you are today. We will discover who you want to be & how you hope to change. I will help you understand your positive, affirming, challenging & disturbing relationships & experiences. We will collaboratively decrease your emotional & physical pain. You will grow to have comfortable & healthy thoughts, feelings & behaviors. I will respectfully guide you towards being mindful with your strength, with your ability to act assertively, with skills to experience self control & contentment & to become who YOU CHOOSE to be.
Together we will create a compassionate & emotionally safe space for you to explore how you became the YOU that you are today. We will discover who you want to be & how you hope to change. I will help you understand your positive, affirming, challenging & disturbing relationships & experiences. We will collaboratively decrease your emotional & physical pain. You will grow to have comfortable & healthy thoughts, feelings & behaviors. I will respectfully guide you towards being mindful with your strength, with your ability to act assertively, with skills to experience self control & contentment & to become who YOU CHOOSE to be.
(269) 215-2957 View (269) 215-2957
Photo of Emily Brooks, LMFT, LLC, Marriage & Family Therapist in Ludlow, VT
Emily Brooks, LMFT, LLC
Marriage & Family Therapist, MA, LMFT
Verified Verified
1 Endorsed
Ludlow, VT 05149
Today's crazy pace of life as well as the stresses of family, money, school, employment, not to mention COVID-19 and politics, it is no wonder more and more people are looking for therapeutic support to find balance in their lives. I will strive to help you find that balance, working with and building on your strengths, already present within you, but lost in the chaos of present day life in a safe, supportive environment. We will work to build coping skills to deal with every day life, when things get tough. Life is full of ups and downs. You can learn new ways to shift your perception, to build on the strengths and positives.
Today's crazy pace of life as well as the stresses of family, money, school, employment, not to mention COVID-19 and politics, it is no wonder more and more people are looking for therapeutic support to find balance in their lives. I will strive to help you find that balance, working with and building on your strengths, already present within you, but lost in the chaos of present day life in a safe, supportive environment. We will work to build coping skills to deal with every day life, when things get tough. Life is full of ups and downs. You can learn new ways to shift your perception, to build on the strengths and positives.
(802) 327-7802 View (802) 327-7802
Photo of Michelle Golden, LCMHC, CIMHP, Licensed Clinical Mental Health Counselor in Ludlow, VT
Michelle Golden, LCMHC, CIMHP
Licensed Clinical Mental Health Counselor, LCMHC, CIMHP
Verified Verified
Ludlow, VT 05149  (Online Only)
Not accepting new clients
Are you feeling overwhelmed, confused, stuck, unsure of what you need? I can help you navigate conflicting feelings, thoughts, and process negative beliefs and experiences which may be holding you back from reaching your true, full potential. I will work to understand all parts of who you are, openly and honestly challenge you, and encourage you to grow. My approach is direct, and transparency is critical in my practice. I will meet you where you are, and walk with you through the "stuff." I take into consideration your environment, social/emotional supports, history, and current coping skills.
Are you feeling overwhelmed, confused, stuck, unsure of what you need? I can help you navigate conflicting feelings, thoughts, and process negative beliefs and experiences which may be holding you back from reaching your true, full potential. I will work to understand all parts of who you are, openly and honestly challenge you, and encourage you to grow. My approach is direct, and transparency is critical in my practice. I will meet you where you are, and walk with you through the "stuff." I take into consideration your environment, social/emotional supports, history, and current coping skills.
(802) 523-3429 View (802) 523-3429

More Therapists Nearby

Photo of Matthew von Unwerth, Licensed Psychoanalyst in Ludlow, VT
Matthew von Unwerth
Licensed Psychoanalyst, PhD, LP, FIPA
Verified Verified
1 Endorsed
Reading, VT 05062
Most mental suffering we endure (if not due to present grief and loss) arises either from our fervent attempts to resolve or answer uncomprehended emotional needs, or because we never learned to endure and adapt our unruly interior lives to the world around us. I help individuals to feel better by attending to all that they are in the moment, as a way of understanding how they have come to be themselves -- and how who they are is at odds with what they want to be and feel. I am trained both in "classical" and contemporary psychoanalysis (IPA member) and in Columbia's pioneering Program in Narrative Medicine, where I now teach.
Most mental suffering we endure (if not due to present grief and loss) arises either from our fervent attempts to resolve or answer uncomprehended emotional needs, or because we never learned to endure and adapt our unruly interior lives to the world around us. I help individuals to feel better by attending to all that they are in the moment, as a way of understanding how they have come to be themselves -- and how who they are is at odds with what they want to be and feel. I am trained both in "classical" and contemporary psychoanalysis (IPA member) and in Columbia's pioneering Program in Narrative Medicine, where I now teach.
(917) 512-5260 View (917) 512-5260
Photo of Erin Boxer, Counselor in Ludlow, VT
Erin Boxer
Counselor, MA, LCMHC, LADC
Verified Verified
Cavendish, VT 05142
Waitlist for new clients
Hello! My name is Erin and I feel honored to be a resource for you in your search of greater emotional wellness and balance. I enjoy working with adults and couples who are looking to make changes in their lives that feel positive to them. I like working to support clients to enhance a positive mind/body connection so that they can improve their relationships to others and to themselves.
Hello! My name is Erin and I feel honored to be a resource for you in your search of greater emotional wellness and balance. I enjoy working with adults and couples who are looking to make changes in their lives that feel positive to them. I like working to support clients to enhance a positive mind/body connection so that they can improve their relationships to others and to themselves.
(802) 684-4387 View (802) 684-4387
Photo of Martha Stretton, Psychologist in Ludlow, VT
Martha Stretton
Psychologist, PhD
Verified Verified
Weston, VT 05161
Not accepting new clients
If you are feeling stuck, confused, or uneasy in your life, I can work with you to help you think clearly, act skillfully, and live authentically.
If you are feeling stuck, confused, or uneasy in your life, I can work with you to help you think clearly, act skillfully, and live authentically.
(802) 695-0162 View (802) 695-0162
Photo of Wendy Stephens, Psychologist in Ludlow, VT
Wendy Stephens
Psychologist, PsyD, MFT
Verified Verified
Chester, VT 05143
I work with a wide variety of people and challenges but I am specially trained in working with couples helping to improve their relationships. I have completed advanced training in Emotion Focused Therapy, the approach for couples that is the most effective longterm. With a shared commitment to work for 1 hour 30 minutes each week we can help change stuck relationship dynamics which cause distress. Additionally, I am a trauma specialist trained in EMDR helping to reducing your symptoms. I have been in private practice for the last 30 years. I am a honest empathic therapist who works hard and collaboratively with you.
I work with a wide variety of people and challenges but I am specially trained in working with couples helping to improve their relationships. I have completed advanced training in Emotion Focused Therapy, the approach for couples that is the most effective longterm. With a shared commitment to work for 1 hour 30 minutes each week we can help change stuck relationship dynamics which cause distress. Additionally, I am a trauma specialist trained in EMDR helping to reducing your symptoms. I have been in private practice for the last 30 years. I am a honest empathic therapist who works hard and collaboratively with you.
(802) 230-1203 View (802) 230-1203
Photo of Vincent Buckholz, Clinical Social Work/Therapist in Ludlow, VT
Vincent Buckholz
Clinical Social Work/Therapist, LICSW
Verified Verified
Chester, VT 05143
Now Accepting New "In Person" and "Tele-Health/ Online" Clients: We are all working as hard as we can to create a quality of life that we can enjoy and share with others. There are times however, when we can use some neutral, non-judgmental assistance with finding and cultivating the changes we need to improve that quality of life. I offer you that environment to consider your potential for change. I provide a collaborative approach to assist you with moving towards structured thinking, while developing resources and resilience to provide a pathway for improving your overall quality of life, as you envision it.
Now Accepting New "In Person" and "Tele-Health/ Online" Clients: We are all working as hard as we can to create a quality of life that we can enjoy and share with others. There are times however, when we can use some neutral, non-judgmental assistance with finding and cultivating the changes we need to improve that quality of life. I offer you that environment to consider your potential for change. I provide a collaborative approach to assist you with moving towards structured thinking, while developing resources and resilience to provide a pathway for improving your overall quality of life, as you envision it.
(802) 448-1351 View (802) 448-1351
Photo of Crissy Webster Counseling Services LLC, Counselor in Ludlow, VT
Crissy Webster Counseling Services LLC
Counselor, MA, LCMHC, NCC
Verified Verified
1 Endorsed
Perkinsville, VT 05151
Waitlist for new clients
Crissy Webster Counseling Services LLC is a small private practice located in Springfield, VT. I am a Licensed Mental Health Counselor who holds licensure in the states of VT and NH, as well as nationally certified through the National Board of Certified Counselors. I see clients of all ages. We have a specialty in Juvenile Firesetting Assessments and Treatment, as well as, adult and adolescent anger management. Through my education and experiences, weI also have knowledge in the areas of Family Systems Model, Trauma Informed Education Practices, ARC, HNC, Parent Training, and perform Trauma Informed Mental Health Evaluations.
Crissy Webster Counseling Services LLC is a small private practice located in Springfield, VT. I am a Licensed Mental Health Counselor who holds licensure in the states of VT and NH, as well as nationally certified through the National Board of Certified Counselors. I see clients of all ages. We have a specialty in Juvenile Firesetting Assessments and Treatment, as well as, adult and adolescent anger management. Through my education and experiences, weI also have knowledge in the areas of Family Systems Model, Trauma Informed Education Practices, ARC, HNC, Parent Training, and perform Trauma Informed Mental Health Evaluations.
(802) 952-8671 View (802) 952-8671
Photo of Glendon Scott Bemis, Drug & Alcohol Counselor in Ludlow, VT
Glendon Scott Bemis
Drug & Alcohol Counselor, LADC, LCMHC, MA
Verified Verified
Chester, VT 05143
I am a dual licensed counselor (Licensed Alcohol and Drug Counselor AND Licensed Clinical Mental Health Counselor) with a background in Opiate addiction and working with Dual diagnosis patients. I am solution focused and believe a combination of trust, teamwork and the right information is the key to success. Specializing in depression, anxiety, addictions, relationship issues (couples counseling) AND court mandated counseling/ CRASH/DUI mandated counseling.
I am a dual licensed counselor (Licensed Alcohol and Drug Counselor AND Licensed Clinical Mental Health Counselor) with a background in Opiate addiction and working with Dual diagnosis patients. I am solution focused and believe a combination of trust, teamwork and the right information is the key to success. Specializing in depression, anxiety, addictions, relationship issues (couples counseling) AND court mandated counseling/ CRASH/DUI mandated counseling.
(802) 560-4032 View (802) 560-4032
Photo of Alexandra Scarlett, Psychologist in Ludlow, VT
Alexandra Scarlett
Psychologist, MA
Verified Verified
North Springfiel, VT 05150  (Online Only)
Waitlist for new clients
I have had over 20 years of experience in private practice treating children, adults, families and couples in a rural area. I am well-versed in common issues such as adjustment disorders, depression and anxiety, childhood trauma and substance abuse and recovery.
I have had over 20 years of experience in private practice treating children, adults, families and couples in a rural area. I am well-versed in common issues such as adjustment disorders, depression and anxiety, childhood trauma and substance abuse and recovery.
(802) 424-9683 View (802) 424-9683
Photo of Christine Reid, Clinical Social Work/Therapist in Ludlow, VT
Christine Reid
Clinical Social Work/Therapist, LICSW, LCSW
Verified Verified
Proctorsville, VT 05153  (Online Only)
As adults, we can carry many layers of stress. Stress that can take a toll on our mental and physical wellbeing, creating tension in our personal and professional experiences, and negatively impacting our quality of life. Often, when we are in this place of limited resiliency, we can find that anxiety and/or depression can take advantage and settle in. Or we find that our relationships or parenting can seem more challenging, leaving us feeling overwhelmed, exhausted or lost. If this is your experience, you're not alone. Together we can move through the stressors, build skills and resiliency; to find a path to peace and hope.
As adults, we can carry many layers of stress. Stress that can take a toll on our mental and physical wellbeing, creating tension in our personal and professional experiences, and negatively impacting our quality of life. Often, when we are in this place of limited resiliency, we can find that anxiety and/or depression can take advantage and settle in. Or we find that our relationships or parenting can seem more challenging, leaving us feeling overwhelmed, exhausted or lost. If this is your experience, you're not alone. Together we can move through the stressors, build skills and resiliency; to find a path to peace and hope.
(802) 278-6803 View (802) 278-6803
Photo of Virginia Kelly, Counselor in Ludlow, VT
Virginia Kelly
Counselor, PhD, LMHC
Verified Verified
Cavendish, VT 05142
There are many reasons you might be here. You may be feeling depressed or anxious - or you may be in the midst of a transition – or trying to process a loss or a life change. I have been in the field of Counseling for 30 + years. I have taught at universities, conducted research, written books, and presented workshops . At the heart of all of that knowledge, the most vital thing I have learned is that it is the quality of our relationships that defines our overall well-being. More importantly, it is ultimately the relationship we have with ourselves that is the key to achieving a sense of connectedness that allows us to thrive.
There are many reasons you might be here. You may be feeling depressed or anxious - or you may be in the midst of a transition – or trying to process a loss or a life change. I have been in the field of Counseling for 30 + years. I have taught at universities, conducted research, written books, and presented workshops . At the heart of all of that knowledge, the most vital thing I have learned is that it is the quality of our relationships that defines our overall well-being. More importantly, it is ultimately the relationship we have with ourselves that is the key to achieving a sense of connectedness that allows us to thrive.
(802) 548-1001 View (802) 548-1001
Photo of Catherine Pither, Intuitive Counseling & Coaching, Licensed Professional Counselor in Ludlow, VT
Catherine Pither, Intuitive Counseling & Coaching
Licensed Professional Counselor, MS
Verified Verified
East Wallingford, VT 05742  (Online Only)
I mainly work with clients who are overcoming the effects of traumatic experiences or loss. These effects may include symptoms of anxiety, depression or unresolved grief.
I mainly work with clients who are overcoming the effects of traumatic experiences or loss. These effects may include symptoms of anxiety, depression or unresolved grief.
(475) 303-7972 View (475) 303-7972
Photo of Zhena Dickinson Hadar, Licensed Professional Counselor in Ludlow, VT
Zhena Dickinson Hadar
Licensed Professional Counselor, LPC
Verified Verified
Mount Holly, VT 05758  (Online Only)
I am an experienced therapist who welcomes individuals and couples who want to find relief and overcome barriers that prevent them from feeling fulfilled. I specialize in working with anxiety, panic disorders, depression, grief, chronic illness, relationship difficulties, parenting challenges, career stress, self-esteem issues as well as trauma.
I am an experienced therapist who welcomes individuals and couples who want to find relief and overcome barriers that prevent them from feeling fulfilled. I specialize in working with anxiety, panic disorders, depression, grief, chronic illness, relationship difficulties, parenting challenges, career stress, self-esteem issues as well as trauma.
(203) 463-4848 View (203) 463-4848

Online Therapists

Photo of Nina La Rosa in Ludlow, VT
Nina La Rosa
BAPsych, MS, NCC
Verified Verified
1 Endorsed
Burlington, VT 05401  (Online Only)
The brain has an immense capacity to change and grow over a lifetime. Clinical research demonstrates even a few months of mindfulness practice can be effective in treating chronic stress, depression, anxiety, addictions, pain, illness, and can boost performance under pressure, enhance relationships, and improve enjoyment of work. I use my professional counseling training, teaching experience, and knowledge of neuroscience to develop with you a set of practical skills you can use daily. I will help you use your strengths to harness the power of your mind and develop skills to uncover more peace, joy, and freedom in your life!
The brain has an immense capacity to change and grow over a lifetime. Clinical research demonstrates even a few months of mindfulness practice can be effective in treating chronic stress, depression, anxiety, addictions, pain, illness, and can boost performance under pressure, enhance relationships, and improve enjoyment of work. I use my professional counseling training, teaching experience, and knowledge of neuroscience to develop with you a set of practical skills you can use daily. I will help you use your strengths to harness the power of your mind and develop skills to uncover more peace, joy, and freedom in your life!
(802) 755-3401 View (802) 755-3401
Photo of Elizabeth (Lizzi) June Buel in Ludlow, VT
Elizabeth (Lizzi) June Buel
MS
Verified Verified
Burlington, VT 05401
Waitlist for new clients
I work with clients who are dealing with a range of difficulties. Through the use of different therapeutic techniques, we can dive deep into past traumas & begin your long waiting healing journey, or work through a current life struggle. Or, I find that some clients simply need an unbiased source to talk through their day-to-day functioning with. If you have a goal that you want to achieve, big or small, we can work to figure out what works best for you. I don't stick to one specific type of therapy in my practice, I believe it is more beneficial to the client if I stay flexible & we find what works best for them & their situation.
I work with clients who are dealing with a range of difficulties. Through the use of different therapeutic techniques, we can dive deep into past traumas & begin your long waiting healing journey, or work through a current life struggle. Or, I find that some clients simply need an unbiased source to talk through their day-to-day functioning with. If you have a goal that you want to achieve, big or small, we can work to figure out what works best for you. I don't stick to one specific type of therapy in my practice, I believe it is more beneficial to the client if I stay flexible & we find what works best for them & their situation.
(802) 255-8293 View (802) 255-8293
Photo of Jennifer Blanchard Counseling, Registered Psychotherapist in Ludlow, VT
Jennifer Blanchard Counseling
Registered Psychotherapist, MS, RN, LLC
Verified Verified
1 Endorsed
Burlington, VT 05401
Waitlist for new clients
We share a universal humanness as we agonize over decisions, struggle with isolation, endure losses, & seek meaning in life. I believe this fundamental connection is at the root of all healing. You yearn for compassionate listening & an empathetic personal engagement in your journey towards positive self-discovery. I want to help you find the freedom to generate new ways of thinking, feeling & acting: to transform unhelpful personal narratives into strength-based versions you can use to flourish. Adult or child, you are uniquely beautiful & vulnerable. Through talk or play, we'll explore how you can live more comfortably as both.
We share a universal humanness as we agonize over decisions, struggle with isolation, endure losses, & seek meaning in life. I believe this fundamental connection is at the root of all healing. You yearn for compassionate listening & an empathetic personal engagement in your journey towards positive self-discovery. I want to help you find the freedom to generate new ways of thinking, feeling & acting: to transform unhelpful personal narratives into strength-based versions you can use to flourish. Adult or child, you are uniquely beautiful & vulnerable. Through talk or play, we'll explore how you can live more comfortably as both.
(802) 402-4533 View (802) 402-4533
Photo of Michael A. Castelli, Counselor in Ludlow, VT
Michael A. Castelli
Counselor, MA, LCMHC
Verified Verified
Middlebury, VT 05753
I offer a welcoming, compassionate, and non-judgmental space to share your story. Sometimes, problems we face — whether they come with a diagnosis or not — may be overwhelming, debilitating, paralyzing, unhealthy, or destructive to ourselves or our relationships. I work collaboratively to help people deconstruct and free themselves from the grip of problems that may be overwhelming and oppressive and move toward preferred ways of living and thriving.
I offer a welcoming, compassionate, and non-judgmental space to share your story. Sometimes, problems we face — whether they come with a diagnosis or not — may be overwhelming, debilitating, paralyzing, unhealthy, or destructive to ourselves or our relationships. I work collaboratively to help people deconstruct and free themselves from the grip of problems that may be overwhelming and oppressive and move toward preferred ways of living and thriving.
(802) 200-2736 View (802) 200-2736

How does your Therapist compare?

Number of Therapists in Ludlow, VT

< 10

Therapists in Ludlow, VT who prioritize treating:

100% Relationship Issues
100% Anxiety
100% Emotional Disturbance
100% Self Esteem
100% Stress
75% Depression
75% ADHD

Average years in practice

25 Years

Top 3 insurances accepted

100% BlueCross and BlueShield
50% Medicaid
50% Medicare

How Therapists in Ludlow, VT see their clients

50% In Person and Online
50% Online Only

Gender breakdown

100% Female
FAQs - About Therapy and Counseling

How can I find a therapist in Ludlow?

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.