Therapists in Issaquah, WA

Photo of Jason Groepper, Marriage & Family Therapist, MS, LMFT
Jason Groepper
Marriage & Family Therapist, MS, LMFT
1 Endorsed
Issaquah, WA 98027
*Now offering online/telehealth options* Do you feel like you and your spouse are drifting apart? Are your children acting out and you don't know how to help them? There is hope! We are all made to have meaningful relationships in our lives. When problems arise, they are often due to issues within our closest interpersonal relationships. I work to impact these significant relationships to help my clients get more joy and satisfaction out of their lives. I work with couples experiencing relationship distress, families recovering from a divorce/separation and parents struggling to raise their children to their fullest potential.
*Now offering online/telehealth options* Do you feel like you and your spouse are drifting apart? Are your children acting out and you don't know how to help them? There is hope! We are all made to have meaningful relationships in our lives. When problems arise, they are often due to issues within our closest interpersonal relationships. I work to impact these significant relationships to help my clients get more joy and satisfaction out of their lives. I work with couples experiencing relationship distress, families recovering from a divorce/separation and parents struggling to raise their children to their fullest potential.
(206) 496-0864 View (206) 496-0864
Photo of Anthea Kwan, Marriage & Family Therapist, MA, LMFT
Anthea Kwan
Marriage & Family Therapist, MA, LMFT
1 Endorsed
Online Only
Now accepting new clients (adults, teens & couples). If you are feeling distressed with tangled emotions on top of dealing with life chaos, I believe you can find peace. Anxiety, depression, and disconnect from our loved ones can bring out parts of us that we may find incongruent to who we want to be. I help individuals and couples find clarity, connection, and authenticity through empathy and a client-centered perspective. Through therapy, you can learn how to untangle messy feelings and live life purposefully.
Now accepting new clients (adults, teens & couples). If you are feeling distressed with tangled emotions on top of dealing with life chaos, I believe you can find peace. Anxiety, depression, and disconnect from our loved ones can bring out parts of us that we may find incongruent to who we want to be. I help individuals and couples find clarity, connection, and authenticity through empathy and a client-centered perspective. Through therapy, you can learn how to untangle messy feelings and live life purposefully.
(425) 842-1437 View (425) 842-1437
Photo of Bonnie Young - Azure Counseling, Marriage & Family Therapist, LMFT, LCSW
Azure Counseling
Marriage & Family Therapist, LMFT, LCSW
1 Endorsed
Issaquah, WA 98027
Welcome to Azure Counseling! We are a group of highly trained and compassionate therapists who serve clients in Washington, Utah, Idaho, Illinois, Massachusetts, Connecticut, and Oklahoma. Our experience spans working with clients with OCD/ religious scrupulosity, relationship distress, family estrangement, grief & loss, sexual concerns, and trauma.
Welcome to Azure Counseling! We are a group of highly trained and compassionate therapists who serve clients in Washington, Utah, Idaho, Illinois, Massachusetts, Connecticut, and Oklahoma. Our experience spans working with clients with OCD/ religious scrupulosity, relationship distress, family estrangement, grief & loss, sexual concerns, and trauma.
(425) 243-1877 View (425) 243-1877
Photo of Samantha Patton, Clinical Social Work/Therapist, MSW, LICSW
Samantha Patton
Clinical Social Work/Therapist, MSW, LICSW
1 Endorsed
Issaquah, WA 98027
You are worthy. You are capable. You are not broken. You can get through this. These are phrases that may be hard to believe for all of us at times due to various life experiences, transitions, or circumstances. While partnering with clients I use a mix of approaches, namely cognitive behavioral therapy (CBT), mindfulness therapy, and acceptance and commitment therapy (ACT). The best fit therapy approach coupled with a strength-based perspective is used to support you in managing emotional distress, increasing self-respect, developing and maintaining new skill sets for coping, and navigating through life’s challenges.
You are worthy. You are capable. You are not broken. You can get through this. These are phrases that may be hard to believe for all of us at times due to various life experiences, transitions, or circumstances. While partnering with clients I use a mix of approaches, namely cognitive behavioral therapy (CBT), mindfulness therapy, and acceptance and commitment therapy (ACT). The best fit therapy approach coupled with a strength-based perspective is used to support you in managing emotional distress, increasing self-respect, developing and maintaining new skill sets for coping, and navigating through life’s challenges.
(425) 382-8144 View (425) 382-8144
Photo of Kyle Takacs, Marriage & Family Therapist Associate, LMFTA, LMHCA, MA, BA
Kyle Takacs
Marriage & Family Therapist Associate, LMFTA, LMHCA, MA, BA
Issaquah, WA 98027
I'm here to help, whether you need individual, couple's, or family therapy. I am committed to creating a safe space for everyone, as an ally for the LGBTQ+ community, and as an advocate for social justice. I serve a diverse clientele of those struggling with, but not limited to, complex trauma, sexual compulsivity/addiction, couple reconciliation, spiritual/religious trauma, family of origin issues, communication, emotional regulation, and relational issues. I will work holistically with you to collaborate and gain a thorough understanding of your unique situation.
I'm here to help, whether you need individual, couple's, or family therapy. I am committed to creating a safe space for everyone, as an ally for the LGBTQ+ community, and as an advocate for social justice. I serve a diverse clientele of those struggling with, but not limited to, complex trauma, sexual compulsivity/addiction, couple reconciliation, spiritual/religious trauma, family of origin issues, communication, emotional regulation, and relational issues. I will work holistically with you to collaborate and gain a thorough understanding of your unique situation.
(425) 842-2380 View (425) 842-2380
Photo of Ashley Spreda, Clinical Social Work/Therapist, MSW, LICSW
Ashley Spreda
Clinical Social Work/Therapist, MSW, LICSW
1 Endorsed
Online Only
I help high-achieving individuals navigate life’s stressors and transitions, including relationship challenges, career shifts, grief,/loss and the anxiety that comes with an ever-changing world. On the outside, you may seem put together, but internally feel stretched thin, stuck in people-pleasing, or unsure how to set boundaries without guilt. Together, we build coping skills, strengthen boundaries, and help you reconnect with what matters so you can feel more grounded and fulfilled. I also support individuals who want to work on breaking unhelpful dating patterns and creating relationships that are more aligned with their values.
I help high-achieving individuals navigate life’s stressors and transitions, including relationship challenges, career shifts, grief,/loss and the anxiety that comes with an ever-changing world. On the outside, you may seem put together, but internally feel stretched thin, stuck in people-pleasing, or unsure how to set boundaries without guilt. Together, we build coping skills, strengthen boundaries, and help you reconnect with what matters so you can feel more grounded and fulfilled. I also support individuals who want to work on breaking unhelpful dating patterns and creating relationships that are more aligned with their values.
(425) 385-0178 View (425) 385-0178
Photo of Siobhan Chandler, Pre-Licensed Professional, PhD
Siobhan Chandler
Pre-Licensed Professional, PhD
1 Endorsed
Issaquah, WA 98027
Waitlist for new clients
If you’re here, something isn’t working the way you need it to. You might feel on edge, flat, or at odds with your life. It could be a situation, a thought, or a pattern that keeps repeating. Or something you’ve been trying to manage on your own for a long time, mostly keeping it to yourself. Sometimes something happens that shakes your sense of stability. Other times, nothing obvious is wrong, but you still have a sense that something’s off or harder than it should be. What’s frustrating is that you’re thoughtful and capable, and you’ve tried to understand what’s going on. But certain patterns still aren’t resolving.
If you’re here, something isn’t working the way you need it to. You might feel on edge, flat, or at odds with your life. It could be a situation, a thought, or a pattern that keeps repeating. Or something you’ve been trying to manage on your own for a long time, mostly keeping it to yourself. Sometimes something happens that shakes your sense of stability. Other times, nothing obvious is wrong, but you still have a sense that something’s off or harder than it should be. What’s frustrating is that you’re thoughtful and capable, and you’ve tried to understand what’s going on. But certain patterns still aren’t resolving.
(425) 406-4394 View (425) 406-4394
Photo of Maria Elena Lara, Psychologist, PhD
Maria Elena Lara
Psychologist, PhD
1 Endorsed
Issaquah, WA 98027
Not accepting new clients
Do you feel distress about the direction in which your life is headed, or wonder why you can't seem to enjoy life like others can? Are your kids driving you crazy?! Call today for your FREE initial phone consultation - I can help! As a psychologist, I can help you to understand not only why you feel debilitated and burdened, but how to overcome these challenges, and thus achieve greater balance in your life. I believe that together, we can make changes that will last, and give you greater hope for the future and a healthy sense of well-being.
Do you feel distress about the direction in which your life is headed, or wonder why you can't seem to enjoy life like others can? Are your kids driving you crazy?! Call today for your FREE initial phone consultation - I can help! As a psychologist, I can help you to understand not only why you feel debilitated and burdened, but how to overcome these challenges, and thus achieve greater balance in your life. I believe that together, we can make changes that will last, and give you greater hope for the future and a healthy sense of well-being.
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Photo of Alexus Marx, Counselor, LMHCA
Alexus Marx
Counselor, LMHCA
Issaquah, WA 98027
Immediate openings available! I specialize in perinatal mental health, but enjoy supporting parents all along the spectrum of their journey to growing a family. I have specialized training and experience working with people that are facing the challenges of trying to conceive, pregnancy/postpartum, unexpected birth experiences, parenting small children, and loss. In addition to this speciality, I have focused my work in supporting teens and adults around themes of trauma, attachment challenges, mood issues (depression/anxiety), identity exploration, self-esteem, relationships, body image, parenting, spirituality, and grief/loss.
Immediate openings available! I specialize in perinatal mental health, but enjoy supporting parents all along the spectrum of their journey to growing a family. I have specialized training and experience working with people that are facing the challenges of trying to conceive, pregnancy/postpartum, unexpected birth experiences, parenting small children, and loss. In addition to this speciality, I have focused my work in supporting teens and adults around themes of trauma, attachment challenges, mood issues (depression/anxiety), identity exploration, self-esteem, relationships, body image, parenting, spirituality, and grief/loss.
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Photo of Vivian Meng, Licensed Mental Health Counselor Associate, MA, LMHCA, CMHS
Vivian Meng
Licensed Mental Health Counselor Associate, MA, LMHCA, CMHS
Issaquah, WA 98027
Waitlist for new clients
I enjoy working with children, teens, and families experiencing anxiety, emotional regulation difficulties, social challenges, behavioral concerns, life transitions, and family or cultural stress. I also have experience working as a behavior therapist supporting neurodivergent children, including autistic clients and children who benefit from additional emotional, behavioral, and social support.
I enjoy working with children, teens, and families experiencing anxiety, emotional regulation difficulties, social challenges, behavioral concerns, life transitions, and family or cultural stress. I also have experience working as a behavior therapist supporting neurodivergent children, including autistic clients and children who benefit from additional emotional, behavioral, and social support.
(425) 585-4131 View (425) 585-4131
Photo of Courtney Hunter, Counselor, MA, LMHC
Courtney Hunter
Counselor, MA, LMHC
Issaquah, WA 98027
As a mental health counselor, I work with adolescents and adults (ages 15–70) who are seeking clarity, healing, and meaningful change during life transitions or emotional challenges. Clients often come to therapy to manage anxiety or depression, process trauma, navigate unexpected life circumstances, or better understand themselves and their relationships. Therapy is a space to explore patterns, strengthen emotional awareness, and develop tools that support growth and self-direction. Together, we work to create a thoughtful and sustainable path forward.
As a mental health counselor, I work with adolescents and adults (ages 15–70) who are seeking clarity, healing, and meaningful change during life transitions or emotional challenges. Clients often come to therapy to manage anxiety or depression, process trauma, navigate unexpected life circumstances, or better understand themselves and their relationships. Therapy is a space to explore patterns, strengthen emotional awareness, and develop tools that support growth and self-direction. Together, we work to create a thoughtful and sustainable path forward.
(253) 342-4842 View (253) 342-4842
Photo of Dr. Rachel Hughes, Marriage & Family Therapist, PhD, LMFT, CMHS
Dr. Rachel Hughes
Marriage & Family Therapist, PhD, LMFT, CMHS
3 Endorsed
Issaquah, WA 98027
You're not broken. You're not difficult. You're not "a lot." But I'd guess you've been told at least one of those things, probably more than once. The people who find their way to me are usually carrying years of trying to fit into systems and spaces that were never designed for them; they're tired, done masking, done explaining themselves, ready for something that actually fits. Most of the people who find their way to me have been failed by systems that weren't built for them. I work with neurodivergent teens, adults, and families across Washington State. I meet you where you are and build from what's already strong.
You're not broken. You're not difficult. You're not "a lot." But I'd guess you've been told at least one of those things, probably more than once. The people who find their way to me are usually carrying years of trying to fit into systems and spaces that were never designed for them; they're tired, done masking, done explaining themselves, ready for something that actually fits. Most of the people who find their way to me have been failed by systems that weren't built for them. I work with neurodivergent teens, adults, and families across Washington State. I meet you where you are and build from what's already strong.
(425) 230-6172 View (425) 230-6172
Photo of Mahogany Sexton, Clinical Social Work/Therapist, MSW, LICSW
Mahogany Sexton
Clinical Social Work/Therapist, MSW, LICSW
Online Only
I’m a Licensed Clinical Social Worker in Washington State with graduate and undergraduate degrees from the University of Washington. Since 2008, I’ve supported individuals and families across medical, mental health, child welfare, and crisis settings. I work with clients of all ages and backgrounds, offering a compassionate, culturally humble space to navigate challenges, build insight, and move toward meaningful change.
I’m a Licensed Clinical Social Worker in Washington State with graduate and undergraduate degrees from the University of Washington. Since 2008, I’ve supported individuals and families across medical, mental health, child welfare, and crisis settings. I work with clients of all ages and backgrounds, offering a compassionate, culturally humble space to navigate challenges, build insight, and move toward meaningful change.
(425) 537-4798 View (425) 537-4798
Photo of Kate Chrisinger, Counselor, MS, LMHC
Kate Chrisinger
Counselor, MS, LMHC
7 Endorsed
Online Only
Welcome! Are you a young adult needing support? Or a parent needing additional parenting strategies, or guidance to better understand/support your child? Are you worried about your child/teen’s emotional well-being or social skills? I enjoy working collaboratively with children and parents alike to improve child and family well-being, often finding that working with both provides the best outcomes for everyone. I have special interests in working with gifted and twice-exceptional (2E) clients and homeschool/online school clients. Lastly I absolutely love working with teens and young adults - they make up a large part of my caseload!
Welcome! Are you a young adult needing support? Or a parent needing additional parenting strategies, or guidance to better understand/support your child? Are you worried about your child/teen’s emotional well-being or social skills? I enjoy working collaboratively with children and parents alike to improve child and family well-being, often finding that working with both provides the best outcomes for everyone. I have special interests in working with gifted and twice-exceptional (2E) clients and homeschool/online school clients. Lastly I absolutely love working with teens and young adults - they make up a large part of my caseload!
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Photo of Dr. Mary Hendrickson, Psychologist, PhD, PsyD
Dr. Mary Hendrickson
Psychologist, PhD, PsyD
Issaquah, WA 98027
Mary is a clinical psychologist who graduated in 1997 from Finch University of Health Sciences/Chicago Medial School (now named the Rosalind Franklin University). She has a PhD focusing on health psychology. She currently works with individual adults, and also has past experience working with children and their families. Her approach to care is that people feel and function best when they have a sense of direction and meaning in life, connection with others, compassion for self and others, and balance in their physical, emotional and social life.
Mary is a clinical psychologist who graduated in 1997 from Finch University of Health Sciences/Chicago Medial School (now named the Rosalind Franklin University). She has a PhD focusing on health psychology. She currently works with individual adults, and also has past experience working with children and their families. Her approach to care is that people feel and function best when they have a sense of direction and meaning in life, connection with others, compassion for self and others, and balance in their physical, emotional and social life.
(425) 243-0615 View (425) 243-0615
Photo of Janet Douglas, Clinical Social Work/Therapist, LICSW, ACHT
Janet Douglas
Clinical Social Work/Therapist, LICSW, ACHT
1 Endorsed
Online Only
Are you wanting to make a change but feeling stuck or unsure? Are you struggling with depression, anxiety, relationship issues, or a trauma that is holding you back? Somatic therapy takes you to the source of negative beliefs and patterns so that you can heal from old wounds. You are better able to see how these patterns may have carried forward, leaving you feeling stuck in your current situation. Through this work, you integrate what no longer serves you and become who you truly want to be.
Are you wanting to make a change but feeling stuck or unsure? Are you struggling with depression, anxiety, relationship issues, or a trauma that is holding you back? Somatic therapy takes you to the source of negative beliefs and patterns so that you can heal from old wounds. You are better able to see how these patterns may have carried forward, leaving you feeling stuck in your current situation. Through this work, you integrate what no longer serves you and become who you truly want to be.
(425) 292-5064 View (425) 292-5064
Photo of Derrick Arciaga, Clinical Social Work/Therapist, MSW, MHP, LICSW, CCM
Derrick Arciaga
Clinical Social Work/Therapist, MSW, MHP, LICSW, CCM
1 Endorsed
Issaquah, WA 98027
In this line of work, it is amazing to see how positive progress is made with patients and how much their lives improve thanks to achieving small victories and through community resources/services. I would like to work with folks who seek to better themselves and create positive change in their lives. Together we could develop coping skills and build upon your strengths to enhance your quality of life.
In this line of work, it is amazing to see how positive progress is made with patients and how much their lives improve thanks to achieving small victories and through community resources/services. I would like to work with folks who seek to better themselves and create positive change in their lives. Together we could develop coping skills and build upon your strengths to enhance your quality of life.
(425) 230-5149 View (425) 230-5149
Photo of Marci Pindi, Clinical Social Work/Therapist, LICSW
Marci Pindi
Clinical Social Work/Therapist, LICSW
Online Only
Welcome! I hold a heartfelt belief that the ability to grow and change holds transformative powers within us all and I'm excited to accompany you on your journey of resiliency. I primarily work with adults and families.
Welcome! I hold a heartfelt belief that the ability to grow and change holds transformative powers within us all and I'm excited to accompany you on your journey of resiliency. I primarily work with adults and families.
(425) 243-0334 View (425) 243-0334
Photo of Liam Wright, Licensed Mental Health Counselor Associate , MA, LMHCA
Liam Wright
Licensed Mental Health Counselor Associate , MA, LMHCA
1 Endorsed
Issaquah, WA 98027
Waitlist for new clients
Let's be real; sometimes life gets tricky and we find ourselves in moments where we feel stuck. We need a little help to process what we’ve been through, to identify who we really are, to start believing that our voice matters, and to figure out a game plan for what we want out of life. As a licensed therapist associate with a clinical music therapy background and a wide breadth of counseling experience, I'm convinced that everyone can benefit from a supportive partner on their courageous journey of growth, healing, and self-discovery. That's what I'm here for!
Let's be real; sometimes life gets tricky and we find ourselves in moments where we feel stuck. We need a little help to process what we’ve been through, to identify who we really are, to start believing that our voice matters, and to figure out a game plan for what we want out of life. As a licensed therapist associate with a clinical music therapy background and a wide breadth of counseling experience, I'm convinced that everyone can benefit from a supportive partner on their courageous journey of growth, healing, and self-discovery. That's what I'm here for!
(425) 474-3618 View (425) 474-3618
Photo of Rashida Ballard, Clinical Social Work/Therapist, MSW, LICSW, CDE
Rashida Ballard
Clinical Social Work/Therapist, MSW, LICSW, CDE
1 Endorsed
Issaquah, WA 98027
My goal is to provide support and guide those who are ready to take the journey of a life well lived. I work with adolescents and adults facing an array of concerns including: ADHD, anxiety, chronic illness, communication barriers, compassion fatigue, depression, grief and loss, imposter syndrome, personal goals and development, professional growth, PTSD, racial identity issues, relationship challenges, self-esteem, spirituality/energy and various forms of trauma. You will be the driving force throughout our time together and with commitment and consistency, I believe you will achieve everything you hope and envision for yourself.
My goal is to provide support and guide those who are ready to take the journey of a life well lived. I work with adolescents and adults facing an array of concerns including: ADHD, anxiety, chronic illness, communication barriers, compassion fatigue, depression, grief and loss, imposter syndrome, personal goals and development, professional growth, PTSD, racial identity issues, relationship challenges, self-esteem, spirituality/energy and various forms of trauma. You will be the driving force throughout our time together and with commitment and consistency, I believe you will achieve everything you hope and envision for yourself.
(425) 386-7991 View (425) 386-7991

See more therapy options for Issaquah

How does your Therapist compare?

Number of Therapists in Issaquah, WA

300+

Average cost per session

$167

Therapists in Issaquah, WA who prioritize treating:

94% Anxiety
94% Social Anxiety
94% Health Anxiety
94% Driving Anxiety
86% Depression
81% Relationship Issues
77% Relationship Anxiety

Average years in practice

11 Years

Top 3 insurances accepted

86% Premera Blue Cross
70% Regence
69% Aetna

How Therapists in Issaquah, WA see their clients

64% In Person and Online
36% Online Only

Gender breakdown

81% Female
18% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Issaquah?

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.