Therapists in Altoona, WI

Photo of Brad Byrum, Marriage & Family Therapist in Altoona, WI
Brad Byrum
Marriage & Family Therapist, LMFT
Verified Verified
Altoona, WI 54720  (Online Only)
Has your relationship become an angry, sad, or scary place leaving you feeling alone, hurt and discouraged? Are you and your partner feeling lost in conflict cycles you don’t understand and desperately want to change? Many of the couples I work with come to therapy feeling just like you. I understand how much courage it takes to reach out for help and to let another person get inside your relationship, especially when you are feeling so vulnerable. If you are searching for a safe place to explore what's not working in your relationship, and support in creating solutions, I can help.
Has your relationship become an angry, sad, or scary place leaving you feeling alone, hurt and discouraged? Are you and your partner feeling lost in conflict cycles you don’t understand and desperately want to change? Many of the couples I work with come to therapy feeling just like you. I understand how much courage it takes to reach out for help and to let another person get inside your relationship, especially when you are feeling so vulnerable. If you are searching for a safe place to explore what's not working in your relationship, and support in creating solutions, I can help.
(715) 638-1784 View (715) 638-1784
Photo of Emily Stephenson, Marriage & Family Therapist in Altoona, WI
Emily Stephenson
Marriage & Family Therapist, LMFT
Verified Verified
Altoona, WI 54720
I work with Wisconsinites who struggle with depression, anxiety, life stressors, eating disorders, and trauma. I use an eclectic approach to bring a tailored therapy experience to my clients because I realize what is helpful for one person may not be helpful for another. My goal in therapy is to understand my client's needs and to do more of what you find benefit from. I am to help my clients improve their mental health by helping them understand themselves, improve their relationships, and improve coping skills.
I work with Wisconsinites who struggle with depression, anxiety, life stressors, eating disorders, and trauma. I use an eclectic approach to bring a tailored therapy experience to my clients because I realize what is helpful for one person may not be helpful for another. My goal in therapy is to understand my client's needs and to do more of what you find benefit from. I am to help my clients improve their mental health by helping them understand themselves, improve their relationships, and improve coping skills.
(715) 312-2470 View (715) 312-2470
Photo of Karah Gonstead, Clinical Social Work/Therapist in Altoona, WI
Karah Gonstead
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Altoona, WI 54720
The populations that I most enjoy working with are tweens, teens, and young adults (ages 11 - 25), as well as Mom's in their perinatal & postpartum journey. I love being able to work youth and adults through life transitions (going into middle/high school/college), struggles in communication, implementation of healthy boundaries, low self-worth, familial dysfunction, etc. Additionally, I have a huge passion for working besides Moms within their journey of motherhood and all of the internal and external transitions that this often includes. If you have questions, please don't hesitate to reach out!
The populations that I most enjoy working with are tweens, teens, and young adults (ages 11 - 25), as well as Mom's in their perinatal & postpartum journey. I love being able to work youth and adults through life transitions (going into middle/high school/college), struggles in communication, implementation of healthy boundaries, low self-worth, familial dysfunction, etc. Additionally, I have a huge passion for working besides Moms within their journey of motherhood and all of the internal and external transitions that this often includes. If you have questions, please don't hesitate to reach out!
(715) 737-9222 View (715) 737-9222
Photo of Christine A Brudnicki, Licensed Professional Counselor in Altoona, WI
Christine A Brudnicki
Licensed Professional Counselor, MS, LPC, C-IAYT
Verified Verified
Altoona, WI 54720
Hello! I have a passion for joining clients at whatever point they are in their journey and walking with them toward health and wellbeing. I take great care to provide an inviting and supportive environment and to meet clients with compassion and acceptance. It is my goal that you feel seen, heard, supported and safe. I strive to create a therapeutic alliance based on respect, allowing clients to be fully present with themselves. It is my belief that each person has within them the courage and resources for healing, and I strive to provide an affirming environment and research backed therapeutic tools to help access these resources.
Hello! I have a passion for joining clients at whatever point they are in their journey and walking with them toward health and wellbeing. I take great care to provide an inviting and supportive environment and to meet clients with compassion and acceptance. It is my goal that you feel seen, heard, supported and safe. I strive to create a therapeutic alliance based on respect, allowing clients to be fully present with themselves. It is my belief that each person has within them the courage and resources for healing, and I strive to provide an affirming environment and research backed therapeutic tools to help access these resources.
(715) 226-4698 View (715) 226-4698
Photo of Gina R Young, Licensed Professional Counselor in Altoona, WI
Gina R Young
Licensed Professional Counselor, MA, LPC
Verified Verified
Altoona, WI 54720
Relationships impact every aspect of our lives. It is especially problematic when the relationship with your spouse or partner is losing hope, joy, and satisfaction. Perhaps the distress is due to communication, betrayal, lack of care, expectations, or other relational issue. If you are experiencing disconnect and pain within your primary relationship, reach out. You do not have to walk through this type of distress alone.
Relationships impact every aspect of our lives. It is especially problematic when the relationship with your spouse or partner is losing hope, joy, and satisfaction. Perhaps the distress is due to communication, betrayal, lack of care, expectations, or other relational issue. If you are experiencing disconnect and pain within your primary relationship, reach out. You do not have to walk through this type of distress alone.
(715) 288-2859 View (715) 288-2859
Photo of Victoria Zweifelhofer, Clinical Social Work/Therapist in Altoona, WI
Victoria Zweifelhofer
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Altoona, WI 54720
My clinical approach is integrative and collaborative as all people are different. Mindfulness is at the core of all approaches I utilize in practice. I utilize Cognitive and Dialectical Behavioral Therapy to help clients build a base of skills to improve their quality of life including decreasing unhealthy coping mechanisms and building healthier relationships. I work with a variety of techniques with individuals who struggle with PTSD or Complex PTSD including Self-Compassion, Prolonged Exposure, and Somatic therapies. I provide tools for clients to practice in between sessions to help them progress toward their individual goals.
My clinical approach is integrative and collaborative as all people are different. Mindfulness is at the core of all approaches I utilize in practice. I utilize Cognitive and Dialectical Behavioral Therapy to help clients build a base of skills to improve their quality of life including decreasing unhealthy coping mechanisms and building healthier relationships. I work with a variety of techniques with individuals who struggle with PTSD or Complex PTSD including Self-Compassion, Prolonged Exposure, and Somatic therapies. I provide tools for clients to practice in between sessions to help them progress toward their individual goals.
(715) 227-2090 View (715) 227-2090
Photo of Allison Bunkelman, Licensed Professional Counselor in Altoona, WI
Allison Bunkelman
Licensed Professional Counselor, MS, LPC
Verified Verified
1 Endorsed
Altoona, WI 54720
Not accepting new clients
I enjoy working with adults within the scope of individual and couples therapy. I strive to create a safe, compassionate, authentic relationship with each person with whom I work with and to personalize therapy to meet the unique needs of each individual.
I enjoy working with adults within the scope of individual and couples therapy. I strive to create a safe, compassionate, authentic relationship with each person with whom I work with and to personalize therapy to meet the unique needs of each individual.
(715) 318-1648 View (715) 318-1648
Photo of Kevin Fisher, Licensed Professional Counselor in Altoona, WI
Kevin Fisher
Licensed Professional Counselor, MA, LPC
Verified Verified
Altoona, WI 54720
I am a provider of professional counseling services, utilizing EMDR therapy and traditional psychotherapy to help with whatever you choose to work on (trauma, PTSD, divorce, relationship issues, substance abuse/dependency, life changes/transitions, depression, anxiety, childhood issues, etc.). I began my clinical work at Austin Recovery, working with individuals facing addiction and the many issues underlying addictive behaviors. During this work, I developed a strong interest in helping individuals deal with past traumatic experiences and negative life events.
I am a provider of professional counseling services, utilizing EMDR therapy and traditional psychotherapy to help with whatever you choose to work on (trauma, PTSD, divorce, relationship issues, substance abuse/dependency, life changes/transitions, depression, anxiety, childhood issues, etc.). I began my clinical work at Austin Recovery, working with individuals facing addiction and the many issues underlying addictive behaviors. During this work, I developed a strong interest in helping individuals deal with past traumatic experiences and negative life events.
(715) 496-6380 View (715) 496-6380
Zachary R Taylor
Licensed Professional Counselor, MA, LPC, NCC
Verified Verified
Altoona, WI 54720
Waitlist for new clients
(715) 962-8430 View (715) 962-8430

More Therapists Nearby

Photo of Cora Reuter Looker, Licensed Professional Counselor in Altoona, WI
Cora Reuter Looker
Licensed Professional Counselor, LPC
Verified Verified
Eau Claire, WI 54701
Passionate about helping others, I offer a space that is safe and genuine to members of the LGBTQIA+ community, and offer services to adults, couples, and adolescents. I have extensive experience and a desire to work with individuals who have experienced the impacts of trauma in their lives. Trauma looks different for everyone and working through those memories, emotions, and body sensations can be both scary and painful. Meeting you where you are at in your journey to create personalized goals with intention is my highest priority.
Passionate about helping others, I offer a space that is safe and genuine to members of the LGBTQIA+ community, and offer services to adults, couples, and adolescents. I have extensive experience and a desire to work with individuals who have experienced the impacts of trauma in their lives. Trauma looks different for everyone and working through those memories, emotions, and body sensations can be both scary and painful. Meeting you where you are at in your journey to create personalized goals with intention is my highest priority.
(715) 402-4115 View (715) 402-4115
Photo of Lou Hang, Marriage & Family Therapist in Altoona, WI
Lou Hang
Marriage & Family Therapist, LMFT
Verified Verified
Eau Claire, WI 54702  (Online Only)
Not accepting new clients
Life can be tough. It can and will throw curveballs at us causing us to experience anxiety, fear, depression, and so much more. We are meant to have life and have it abundantly, but these curveballs make it so so difficult to enjoy life. This is one of the reasons why I entered this field so that I can come alongside those who've been stuck in these curveballs, those who've lost hope. You are not alone in your struggles. Together, we will work on identifying your problems, needs, and goals so that you can have life and have it abundantly.
Life can be tough. It can and will throw curveballs at us causing us to experience anxiety, fear, depression, and so much more. We are meant to have life and have it abundantly, but these curveballs make it so so difficult to enjoy life. This is one of the reasons why I entered this field so that I can come alongside those who've been stuck in these curveballs, those who've lost hope. You are not alone in your struggles. Together, we will work on identifying your problems, needs, and goals so that you can have life and have it abundantly.
(920) 654-5027 View (920) 654-5027
Photo of Northern Woods Wellness LLC, Licensed Professional Counselor in Altoona, WI
Northern Woods Wellness LLC
Licensed Professional Counselor, MA, NCC, LPC
Verified Verified
Eau Claire, WI 54703
Hi! I am Timothy R. Foster, MA, LPC in WI & MN. My style of therapy is unique. It is designed to engage the full person and to integrate our past, present, and future experiences into a congruent and comprehensive image of our true selves. Life is difficult. It just is. Learning to accept our emotional experiences honestly and non-judgementally can be hard. But this is where I truly believe healing is created. I work well with clients who like to ask tough questions and are willing to be open with their experiences with me. I will provide a direct and compassionate approach. You will get to know me just as much as I get to know you!
Hi! I am Timothy R. Foster, MA, LPC in WI & MN. My style of therapy is unique. It is designed to engage the full person and to integrate our past, present, and future experiences into a congruent and comprehensive image of our true selves. Life is difficult. It just is. Learning to accept our emotional experiences honestly and non-judgementally can be hard. But this is where I truly believe healing is created. I work well with clients who like to ask tough questions and are willing to be open with their experiences with me. I will provide a direct and compassionate approach. You will get to know me just as much as I get to know you!
(715) 200-8312 View (715) 200-8312
Photo of Jeannie Lindskog, Licensed Professional Counselor in Altoona, WI
Jeannie Lindskog
Licensed Professional Counselor, MA, LPC, PSC
Verified Verified
Eau Claire, WI 54702  (Online Only)
Do you find yourself suffering from more stress and anxiety than usual? I offer exclusively online therapy sessions. I work with clients to raise their self-awareness, understanding and acceptance, in order to facilitate the changes they desire. I work with adults and adolescents around issues of depression, anxiety, stress, loss, family and marital relationships . I have over 30 years of experience and my clinical background spans across age, gender, racial/ethnic groups, sexual orientation and socioeconomic status. I offer empathy, experience and a non-judgmental approach in the therapeutic relationship.
Do you find yourself suffering from more stress and anxiety than usual? I offer exclusively online therapy sessions. I work with clients to raise their self-awareness, understanding and acceptance, in order to facilitate the changes they desire. I work with adults and adolescents around issues of depression, anxiety, stress, loss, family and marital relationships . I have over 30 years of experience and my clinical background spans across age, gender, racial/ethnic groups, sexual orientation and socioeconomic status. I offer empathy, experience and a non-judgmental approach in the therapeutic relationship.
(262) 279-1733 View (262) 279-1733
Photo of Heather Heide, Marriage & Family Therapist in Altoona, WI
Heather Heide
Marriage & Family Therapist, LMFT, CSAT
Verified Verified
Eau Claire, WI 54701
Waitlist for new clients
Relationships are the guiding forces in our lives for connection and where we learn to create meaning. I have built my practice exploring the unique needs of people struggling with the complexities of trauma and addictions. I have learned to understand the nuances and struggles that couples and families face in the discovery process of addictions as well as the daily impacts of living with secrets. Moving beyond secrets can be a difficult, but I can help guide you through it in an efficient and thoughtful manner. I believe change is collaborative process where trust, laughter, and safety are essential to the therapeutic journey.
Relationships are the guiding forces in our lives for connection and where we learn to create meaning. I have built my practice exploring the unique needs of people struggling with the complexities of trauma and addictions. I have learned to understand the nuances and struggles that couples and families face in the discovery process of addictions as well as the daily impacts of living with secrets. Moving beyond secrets can be a difficult, but I can help guide you through it in an efficient and thoughtful manner. I believe change is collaborative process where trust, laughter, and safety are essential to the therapeutic journey.
(952) 260-9331 View (952) 260-9331
Photo of Monica Lindahl, Marriage & Family Therapist in Altoona, WI
Monica Lindahl
Marriage & Family Therapist, MA, LMFT, MBA
Verified Verified
2 Endorsed
Eau Claire, WI 54701  (Online Only)
Does worrying get in the way of day-to-day life? Are seemingly small tasks overwhelming? Do changes feel too much to handle? Is food a source of comfort for you? Does your eating feel out of control? As a team we can address these concerns and more. I specialize in treating anxiety, panic and binge eating. You CAN learn new ways of tackling problems, improve your emotional wellbeing, and feel more confident with your decisions throughout your day. We will work together to guide you to self-compassion and a sense of peace.
Does worrying get in the way of day-to-day life? Are seemingly small tasks overwhelming? Do changes feel too much to handle? Is food a source of comfort for you? Does your eating feel out of control? As a team we can address these concerns and more. I specialize in treating anxiety, panic and binge eating. You CAN learn new ways of tackling problems, improve your emotional wellbeing, and feel more confident with your decisions throughout your day. We will work together to guide you to self-compassion and a sense of peace.
(612) 439-2238 View (612) 439-2238
Photo of Katt Cochran, Psychologist in Altoona, WI
Katt Cochran
Psychologist, PhD
Verified Verified
1 Endorsed
Eau Claire, WI 54702
We all struggle with navigating our lives at some time or another. Whether it be with who we are, relationships in our lives, day-to-day stress, or the compounding challenges of all of the above - we need help. As a licensed psychologist and non-binary, queer, liberation-focused therapist, I am dedicated to providing a transformative therapeutic experience that centers on your journey toward self-empowerment and joy. My practice is founded on the belief that every individual deserves a space where they can explore, heal, and thrive without fear of judgment or marginalization.
We all struggle with navigating our lives at some time or another. Whether it be with who we are, relationships in our lives, day-to-day stress, or the compounding challenges of all of the above - we need help. As a licensed psychologist and non-binary, queer, liberation-focused therapist, I am dedicated to providing a transformative therapeutic experience that centers on your journey toward self-empowerment and joy. My practice is founded on the belief that every individual deserves a space where they can explore, heal, and thrive without fear of judgment or marginalization.
(414) 895-0025 View (414) 895-0025
Photo of Stephanie Hurlburt, Clinical Social Work/Therapist in Altoona, WI
Stephanie Hurlburt
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Eau Claire, WI 54701
Do you find yourself dwelling on the past or worrying about the future? Are you feeling emotionally or mentally disconnected with yourself or in your relationships? Or maybe (if you're really being honest) there's a gap between what you know to be true about your Christian faith and what you actually believe in your heart? Stress and trauma can leave us feeling disconnected in so many ways. As a Christian therapist specializing in trauma, I help clients understand the deep impacts of trauma, while also supporting them in rebuilding a healthy connection with their body, soul, and spirit.
Do you find yourself dwelling on the past or worrying about the future? Are you feeling emotionally or mentally disconnected with yourself or in your relationships? Or maybe (if you're really being honest) there's a gap between what you know to be true about your Christian faith and what you actually believe in your heart? Stress and trauma can leave us feeling disconnected in so many ways. As a Christian therapist specializing in trauma, I help clients understand the deep impacts of trauma, while also supporting them in rebuilding a healthy connection with their body, soul, and spirit.
(715) 500-4611 View (715) 500-4611
Photo of Kimber Sorvaag, Clinical Social Work/Therapist in Altoona, WI
Kimber Sorvaag
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Eau Claire, WI 54701
As a therapist, I believe in a collaborative journey toward healing and growth, meeting my clients exactly where they are in their unique experiences. Through a compassionate and client-centered approach, I strive to create a safe space for exploration and empowerment, fostering resilience and meaningful change together. Let's embark on this journey of self-discovery and transformation, side by side.
As a therapist, I believe in a collaborative journey toward healing and growth, meeting my clients exactly where they are in their unique experiences. Through a compassionate and client-centered approach, I strive to create a safe space for exploration and empowerment, fostering resilience and meaningful change together. Let's embark on this journey of self-discovery and transformation, side by side.
(715) 260-3328 View (715) 260-3328
Photo of Julianna Tavale, Pre-Licensed Professional in Altoona, WI
Julianna Tavale
Pre-Licensed Professional, MSW, APSW
Verified Verified
Eau Claire, WI 54701
I believe in creating a safe space for clients in order to collaborate as a team and to help individuals succeed in self-growth, quality of life enjoyment, and empowerment. I am skilled in providing support for adults experiencing challenges with anxiety, depression, relationship difficulties, negative self-image, communication and trauma. I support assisting individuals in identifying negative coping patterns and growth of adapting and learning new coping skills and adjusting those to benefit day-to-day life functioning.
I believe in creating a safe space for clients in order to collaborate as a team and to help individuals succeed in self-growth, quality of life enjoyment, and empowerment. I am skilled in providing support for adults experiencing challenges with anxiety, depression, relationship difficulties, negative self-image, communication and trauma. I support assisting individuals in identifying negative coping patterns and growth of adapting and learning new coping skills and adjusting those to benefit day-to-day life functioning.
(715) 489-5239 x176 View (715) 489-5239 x176
Photo of Kaileen McMickle, Licensed Professional Counselor in Altoona, WI
Kaileen McMickle
Licensed Professional Counselor, MS, LPC, CCATP
Verified Verified
Eau Claire, WI 54701  (Online Only)
Your anxiety is more than just an uncomfortable force in your body. It colludes with shame, keeping you in an unceasing cycle of fear, avoidance, and self-criticism. On one end of the pendulum, your anxiety invites a visceral sense of dread and a baseline of unrelenting distress; on the other, it cracks hard against your sense of self-worth, belonging, and value. You want an escape: to feel capable, self-assured, and led by what matters to you in life. You want to securely connect to yourself; to trust yourself. You want to feel fiercely empowered.
Your anxiety is more than just an uncomfortable force in your body. It colludes with shame, keeping you in an unceasing cycle of fear, avoidance, and self-criticism. On one end of the pendulum, your anxiety invites a visceral sense of dread and a baseline of unrelenting distress; on the other, it cracks hard against your sense of self-worth, belonging, and value. You want an escape: to feel capable, self-assured, and led by what matters to you in life. You want to securely connect to yourself; to trust yourself. You want to feel fiercely empowered.
(715) 954-8289 View (715) 954-8289

See more therapy options for Altoona

How does your Therapist compare?

Number of Therapists in Altoona, WI

< 10

Therapists in Altoona, WI who prioritize treating:

89% Relationship Issues
78% Anxiety
78% Life Transitions
67% Depression
56% Grief
56% Trauma and PTSD
56% Self Esteem

Average years in practice

12 Years

Top 3 insurances accepted

75% Other
50% BlueCross and BlueShield
50% Medica

How Therapists in Altoona, WI see their clients

89% In Person and Online
11% Online Only

Gender breakdown

84% Female
16% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Altoona?

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.