Therapists in Charleston, WV

Photo of Diane Briers Hendricks, Clinical Social Work/Therapist, LICSW
Diane Briers Hendricks
Clinical Social Work/Therapist, LICSW
Charleston, WV 25301
I work predominantly with adults ages 21-81. About 20% of my practice consists of families or couples. Common themes for therapy are family conflict, romantic relationships or lack of, chronic illness, anxiety and depression.
I work predominantly with adults ages 21-81. About 20% of my practice consists of families or couples. Common themes for therapy are family conflict, romantic relationships or lack of, chronic illness, anxiety and depression.
(304) 301-5116 View (304) 301-5116
Photo of Kpcc Counseling - KPCC Counseling, Counselor, LPC, LCSW
KPCC Counseling
Counselor, LPC, LCSW
Charleston, WV 25301
KPCC Counseling - Voted #1 Counseling Center in West Virginia two years in a row. Convenient locations, free parking, flexible scheduling. KPCC Counseling has licensed counselors who are well trained in a number of different kinds of counseling. We match you and your goals with the counselor who will be the best fit for you. Our counselors are known for being positive, open, accepting, and available. Kathy Muscari- Andy Counts - Vanessa Landgrave- Sarah Stanley - Kerrie Harris - Paige Winfree - Jaime Richmond - Bessie Tadlock-Jimenez - Susan Armentrout - Pamela Blue- Brittany Powell- Hollie McClanahan.
KPCC Counseling - Voted #1 Counseling Center in West Virginia two years in a row. Convenient locations, free parking, flexible scheduling. KPCC Counseling has licensed counselors who are well trained in a number of different kinds of counseling. We match you and your goals with the counselor who will be the best fit for you. Our counselors are known for being positive, open, accepting, and available. Kathy Muscari- Andy Counts - Vanessa Landgrave- Sarah Stanley - Kerrie Harris - Paige Winfree - Jaime Richmond - Bessie Tadlock-Jimenez - Susan Armentrout - Pamela Blue- Brittany Powell- Hollie McClanahan.
(304) 519-0960 View (304) 519-0960
Photo of Sarah E Shapero, Clinical Social Work/Therapist, LICSW
Sarah E Shapero
Clinical Social Work/Therapist, LICSW
Charleston, WV 25314
I specialize in helping people to improve the relationship they have with themselves.
I specialize in helping people to improve the relationship they have with themselves.
(304) 652-5615 View (304) 652-5615
Photo of Julie Williams, Clinical Social Work/Therapist, LCSW-S
Julie Williams
Clinical Social Work/Therapist, LCSW-S
2 Endorsed
Charleston, WV 25311
Hello! My name is Julie Williams, LCSW-S. I am a seasoned mental health professional with 20 years’ experience. Helping you achieve your optimal health is my goal. To me, this means first and foremost, your emotional, physical and spiritual wellbeing are my highest priority. My practice involves, but is not limited to, providing psychotherapy to address issues such as anxiety, depression, bipolar, panic disorder, grief, and those with a history of trauma.
Hello! My name is Julie Williams, LCSW-S. I am a seasoned mental health professional with 20 years’ experience. Helping you achieve your optimal health is my goal. To me, this means first and foremost, your emotional, physical and spiritual wellbeing are my highest priority. My practice involves, but is not limited to, providing psychotherapy to address issues such as anxiety, depression, bipolar, panic disorder, grief, and those with a history of trauma.
(859) 517-4590 View (859) 517-4590
Photo of Dana McMaster - Harmony, A Member of Transformations Care Network, Licensed Professional Counselor, LPC, NCC, AADC
Harmony, A Member of Transformations Care Network
Licensed Professional Counselor, LPC, NCC, AADC
Charleston, WV 25311
Harmony, A Member of Transformations Care Network, is the resource of choice for mental health care in the Charleston, West Virginia community. We are a practice of board certified psychiatrists and therapists, working to provide our community with support and treatment for a variety of diagnoses including depression, anxiety, bipolar disorder, schizophrenia, ADHD, substance abuse, body image, and more. We provide individual therapy for children, teens and adults. Our experienced providers work with you or your loved one to address symptoms, improve quality of life, and restore balance.
Harmony, A Member of Transformations Care Network, is the resource of choice for mental health care in the Charleston, West Virginia community. We are a practice of board certified psychiatrists and therapists, working to provide our community with support and treatment for a variety of diagnoses including depression, anxiety, bipolar disorder, schizophrenia, ADHD, substance abuse, body image, and more. We provide individual therapy for children, teens and adults. Our experienced providers work with you or your loved one to address symptoms, improve quality of life, and restore balance.
(681) 252-9588 View (681) 252-9588
Photo of Christina Hill, Licensed Professional Counselor, MA, LPC, ALPS
Christina Hill
Licensed Professional Counselor, MA, LPC, ALPS
Charleston, WV 25301
Peace of Mind Therapy & Wellness is an independent private practice in Charleston, WV. At my practice, I am dedicated to providing quality counseling services in a warm and welcoming atmosphere. I have over 12 plus years of experience in the Mental Health field working in multiple settings including hospital, community, educational, and private practice. I specialize in the treatment of children, adolescents, and families who are struggling with emotional, behavioral, and relationship issues. My therapy style is warm, interactive, and empowering. I believe in treating everyone with respect, sensitivity, and compassion.
Peace of Mind Therapy & Wellness is an independent private practice in Charleston, WV. At my practice, I am dedicated to providing quality counseling services in a warm and welcoming atmosphere. I have over 12 plus years of experience in the Mental Health field working in multiple settings including hospital, community, educational, and private practice. I specialize in the treatment of children, adolescents, and families who are struggling with emotional, behavioral, and relationship issues. My therapy style is warm, interactive, and empowering. I believe in treating everyone with respect, sensitivity, and compassion.
(304) 621-6220 View (304) 621-6220
Photo of Chava Kristin Clendinning, Licensed Professional Counselor, MA, LPC, NCC
Chava Kristin Clendinning
Licensed Professional Counselor, MA, LPC, NCC
Charleston, WV 25301
Waitlist for new clients
I believe everyone is entitled to sound mental health. No matter who you are, you should be given the opportunity to improve your mental wellness through ethical and sound clinical interventions. I am a natural born cheerleader and am committed to walking with you through some of life's most rigorous challenges.
I believe everyone is entitled to sound mental health. No matter who you are, you should be given the opportunity to improve your mental wellness through ethical and sound clinical interventions. I am a natural born cheerleader and am committed to walking with you through some of life's most rigorous challenges.
(304) 486-3815 View (304) 486-3815
Photo of Amanda Kevey, Clinical Social Work/Therapist, MSW
Amanda Kevey
Clinical Social Work/Therapist, MSW
Charleston, WV 25314
I believe that prioritizing mental health is essential for overall well-being and healthy functioning throughout life. I have been providing therapy services for six years, specializing in trauma treatment for children, adolescents, and adults. In addition to trauma treatment, I work with clients to help reduce symptoms of anxiety, depression, anger, and other forms of emotional dysregulation.
I believe that prioritizing mental health is essential for overall well-being and healthy functioning throughout life. I have been providing therapy services for six years, specializing in trauma treatment for children, adolescents, and adults. In addition to trauma treatment, I work with clients to help reduce symptoms of anxiety, depression, anger, and other forms of emotional dysregulation.
(681) 202-9487 View (681) 202-9487
Photo of Angel Hiles, Counselor, MAEd, LPCC-S, LPC
Angel Hiles
Counselor, MAEd, LPCC-S, LPC
Charleston, WV 25301
You’re used to having it all together—thriving in your career, managing responsibilities, and meeting expectations. But inside, you feel overwhelmed or disconnected. Maybe you’re grappling with divorce, trauma, or anxiety. Or, you’re stuck in people-pleasing patterns, struggling to manage your ADHD, or facing relationship challenges. Ongoing self-doubt and low self-esteem impact your daily life, but you aren’t sure how to move forward. These experiences can leave you feeling isolated and frozen, even when everything on the outside looks ‘fine.’ Regardless of where you are, you don’t have to go through this alone.
You’re used to having it all together—thriving in your career, managing responsibilities, and meeting expectations. But inside, you feel overwhelmed or disconnected. Maybe you’re grappling with divorce, trauma, or anxiety. Or, you’re stuck in people-pleasing patterns, struggling to manage your ADHD, or facing relationship challenges. Ongoing self-doubt and low self-esteem impact your daily life, but you aren’t sure how to move forward. These experiences can leave you feeling isolated and frozen, even when everything on the outside looks ‘fine.’ Regardless of where you are, you don’t have to go through this alone.
(304) 249-9644 View (304) 249-9644
Photo of Jill Garrett, APRN, FNP-BC
Jill Garrett
Verified Verified
1 Endorsed
Online Only
My ideal client is someone struggling with weight management and seeking a sustainable, balanced approach to improve their health. They may feel overwhelmed by diets that don’t work or unsure how to start a lifestyle change. They want personalized guidance, compassionate support, and a plan that fits their unique goals to achieve lasting results.
My ideal client is someone struggling with weight management and seeking a sustainable, balanced approach to improve their health. They may feel overwhelmed by diets that don’t work or unsure how to start a lifestyle change. They want personalized guidance, compassionate support, and a plan that fits their unique goals to achieve lasting results.
(304) 486-3229 View (304) 486-3229
Photo of Angela Brogan, Pre-Licensed Professional, MA
Angela Brogan
Pre-Licensed Professional, MA
Charleston, WV 25311
I am a holistic trauma therapist who helps others find a balanced, authentic way to view themselves and the world around them. While I frequently employ CBT and thought challenging in sessions, I also believe a mind-body approach is necessary for deep healing. Why? Because our minds are designed to seek safety before learning and personal growth. For those of us with trauma, our bodies have served us well in this capacity, helping us find safety in the chaos of trauma. But now, these trauma-trained bodies struggle to recognize and navigate safer worlds.
I am a holistic trauma therapist who helps others find a balanced, authentic way to view themselves and the world around them. While I frequently employ CBT and thought challenging in sessions, I also believe a mind-body approach is necessary for deep healing. Why? Because our minds are designed to seek safety before learning and personal growth. For those of us with trauma, our bodies have served us well in this capacity, helping us find safety in the chaos of trauma. But now, these trauma-trained bodies struggle to recognize and navigate safer worlds.
(304) 451-5605 View (304) 451-5605
Photo of Allyson Hedges - Crescent Counseling Group, Licensed Professional Counselor, LPC, ALPS
Crescent Counseling Group
Licensed Professional Counselor, LPC, ALPS
Charleston, WV 25302
Not accepting new clients
There is no need to struggle in silence. Life can become overwhelming, confusing, and difficult to manage. Do you find yourself repeating past patterns and behaviors that are destructive? Therapy is a place to regain a sense of self and purpose. Together we will find your strengths, re-examine harmful patterns, and reconnect you to a healthy life where you feel connected and fulfilled. I have over twenty-four years of working as a licensed therapist (WV LPC). I am a Certified EMDR therapist. I also have training in other evidence-based treatment modalities including Emotionally Focused Therapy and AEDP.
There is no need to struggle in silence. Life can become overwhelming, confusing, and difficult to manage. Do you find yourself repeating past patterns and behaviors that are destructive? Therapy is a place to regain a sense of self and purpose. Together we will find your strengths, re-examine harmful patterns, and reconnect you to a healthy life where you feel connected and fulfilled. I have over twenty-four years of working as a licensed therapist (WV LPC). I am a Certified EMDR therapist. I also have training in other evidence-based treatment modalities including Emotionally Focused Therapy and AEDP.
(304) 316-6969 View (304) 316-6969
Photo of Stephanie Todd - Life Strategies Counseling, Pre-Licensed Professional, PLPC
Life Strategies Counseling
Pre-Licensed Professional, PLPC
Charleston, WV 25304
Since 2001 we have helped thousands of people navigate life challenges on a path to betterment. We have a multi-discipline team spanning a plethora of services including help for the following challenges: Relational, Behavioral, Anxiety, Depression, Addiction, Trauma, Marriage, Grief, Attention Deficit, Adjustment, Stress, Dysphoria, Post Traumatic Stress, Loneliness, Career Development, Job-Related Stress, School Problems, Learning Issues, Autism.
Since 2001 we have helped thousands of people navigate life challenges on a path to betterment. We have a multi-discipline team spanning a plethora of services including help for the following challenges: Relational, Behavioral, Anxiety, Depression, Addiction, Trauma, Marriage, Grief, Attention Deficit, Adjustment, Stress, Dysphoria, Post Traumatic Stress, Loneliness, Career Development, Job-Related Stress, School Problems, Learning Issues, Autism.
(304) 484-4389 View (304) 484-4389
Photo of Briana Washington, Clinical Social Work/Therapist, MSW
Briana Washington
Clinical Social Work/Therapist, MSW
1 Endorsed
Charleston, WV 25302
Life is full of ups and downs. It can be overwhelming, confusing, challenging or just plain hard! We all need support to maneuver our way through the uncertainties that life can bring - traumatic experiences, loss of a loved one or even struggles with self esteem.  Having a safe space to sort out these thoughts and feelings is key. I will use my holistic approach to focus on healing the whole person. We will work together to build resilience and develop skills to help you on your journey so you can feel confident while facing life's challenges.
Life is full of ups and downs. It can be overwhelming, confusing, challenging or just plain hard! We all need support to maneuver our way through the uncertainties that life can bring - traumatic experiences, loss of a loved one or even struggles with self esteem.  Having a safe space to sort out these thoughts and feelings is key. I will use my holistic approach to focus on healing the whole person. We will work together to build resilience and develop skills to help you on your journey so you can feel confident while facing life's challenges.
(304) 318-7527 View (304) 318-7527
Photo of Stephanie Knight Clarke, Licensed Professional Counselor, LPC, NCC, P-MHC
Stephanie Knight Clarke
Licensed Professional Counselor, LPC, NCC, P-MHC
Charleston, WV 25302
Deciding you are ready to make a lifelong change can be a difficult decision, or maybe you are ready to start living the life you have envisioned and the choice is obvious. Either way, our team of qualified professionals is ready to work with you to help you determine specific goals that will improve your quality of life and enrich your relationships. We invite you into our comfortable environment. We will maintain a caring and non-judgmental stance, and will patiently follow your lead to your path to peace.
Deciding you are ready to make a lifelong change can be a difficult decision, or maybe you are ready to start living the life you have envisioned and the choice is obvious. Either way, our team of qualified professionals is ready to work with you to help you determine specific goals that will improve your quality of life and enrich your relationships. We invite you into our comfortable environment. We will maintain a caring and non-judgmental stance, and will patiently follow your lead to your path to peace.
(681) 201-1417 View (681) 201-1417
Photo of Desiree Hughes - The Concrete Rose Therapy Services, Clinical Social Work/Therapist, MS, LICSW, LCSW
The Concrete Rose Therapy Services
Clinical Social Work/Therapist, MS, LICSW, LCSW
Online Only
Hi! My name is Desiree Hughes, CEO and provider for The Concrete Rose: Therapy Services. While I specialize in both childhood & adulthood trauma and the typical symptoms that often accompany this (ptsd, anxiety, depression, self-esteem issues, relationship-conflict, perfectionism), I also tend to work well with people who are motivated & ready to...bloom, if you will. I am well versed in adults with ADHD, young adults, life stressors/transitions, postpartum struggles, and challenges in parenting.
Hi! My name is Desiree Hughes, CEO and provider for The Concrete Rose: Therapy Services. While I specialize in both childhood & adulthood trauma and the typical symptoms that often accompany this (ptsd, anxiety, depression, self-esteem issues, relationship-conflict, perfectionism), I also tend to work well with people who are motivated & ready to...bloom, if you will. I am well versed in adults with ADHD, young adults, life stressors/transitions, postpartum struggles, and challenges in parenting.
(304) 885-1978 View (304) 885-1978
Photo of Ashley J Holtsclaw, Licensed Professional Counselor, MA, LPC, ALPS, NCC, CCTP, CDBT
Ashley J Holtsclaw
Licensed Professional Counselor, MA, LPC, ALPS, NCC, CCTP, CDBT
Charleston, WV 25302
Hi, I'm here to support anyone dealing with stress, anxiety, substance abuse, interpersonal difficulties, and various other challenges. Feeling overwhelmed? You're not alone. It takes courage to seek help, but I'm here to walk alongside you. My approach is centered on you, ensuring you feel supported every step of the way. I offer and integrated Solutions-Focused and Humanistic Approach in which you are the expert of your life. I am a supportive guide to help you overcome adversities so that you can achieve results. Together, we'll tackle barriers and equip you with coping skills to navigate life confidently for balance and healing.
Hi, I'm here to support anyone dealing with stress, anxiety, substance abuse, interpersonal difficulties, and various other challenges. Feeling overwhelmed? You're not alone. It takes courage to seek help, but I'm here to walk alongside you. My approach is centered on you, ensuring you feel supported every step of the way. I offer and integrated Solutions-Focused and Humanistic Approach in which you are the expert of your life. I am a supportive guide to help you overcome adversities so that you can achieve results. Together, we'll tackle barriers and equip you with coping skills to navigate life confidently for balance and healing.
(681) 201-1343 View (681) 201-1343
Photo of Jack Alan Copley, Marriage & Family Therapist, DMin, LMFT, CST
Jack Alan Copley
Marriage & Family Therapist, DMin, LMFT, CST
Online Only
Not accepting new clients
I am a Licensed Marriage and Family Therapist and an AASECT Certified Sex Therapist who provides Telehealth appointments to people living in Charleston and throughout WV. I am open and affirming of all persons-regardless of sexual orientation, gender, age, race, faith, or marital status. People see me for a variety of needs, such as couples therapy, individual therapy, recovery after an affair, grief, or a traumatic personal history.
I am a Licensed Marriage and Family Therapist and an AASECT Certified Sex Therapist who provides Telehealth appointments to people living in Charleston and throughout WV. I am open and affirming of all persons-regardless of sexual orientation, gender, age, race, faith, or marital status. People see me for a variety of needs, such as couples therapy, individual therapy, recovery after an affair, grief, or a traumatic personal history.
(304) 205-0695 View (304) 205-0695
Photo of Ashley Holtsclaw - Inspiring Horizons Counseling & Wellness, LLC, Licensed Professional Counselor, MA, LPC, ALPS, NCC, BC-TMH, ASDCS,
Inspiring Horizons Counseling & Wellness, LLC
Licensed Professional Counselor, MA, LPC, ALPS, NCC, BC-TMH, ASDCS,
Charleston, WV 25302
Do you struggle with feeling disconnected from yourself and others? Do you put your needs at the bottom of the to-do list? Do you wonder if life should feel somehow better? Happier? Now more than ever, people are feeling anxious, overwhelmed and uncertain about how they are supposed to manage their relationships, careers and their lives. Pushing away your needs and not taking time for yourself can lead to long-term issues for your mind and body. We believe it shouldn’t be so hard to live a better life! Our passion is to help others find positive ways to live a balanced life, reduce mental health stigma, and to promote healing.
Do you struggle with feeling disconnected from yourself and others? Do you put your needs at the bottom of the to-do list? Do you wonder if life should feel somehow better? Happier? Now more than ever, people are feeling anxious, overwhelmed and uncertain about how they are supposed to manage their relationships, careers and their lives. Pushing away your needs and not taking time for yourself can lead to long-term issues for your mind and body. We believe it shouldn’t be so hard to live a better life! Our passion is to help others find positive ways to live a balanced life, reduce mental health stigma, and to promote healing.
(304) 427-5596 View (304) 427-5596
Photo of Dr. Sarah Joan Davis-Williamson, Clinical Social Work/Therapist, DSW, LICSW
Dr. Sarah Joan Davis-Williamson
Clinical Social Work/Therapist, DSW, LICSW
Charleston, WV 25301
If you are seeking assistance with intrusive thoughts or troubling behavior, like checking the locks repeatedly, then I may be of service. I have experience with PTSD, depression, and anxiety. If you struggle getting along with coworkers or even friends and family, we can work to improve those relationships. Isolation does not fix the problem, it further damages those relationships and leaves you feeling alone. Anger and anxiety are natural feelings. However, sometimes controlling them can be easier said than done.
If you are seeking assistance with intrusive thoughts or troubling behavior, like checking the locks repeatedly, then I may be of service. I have experience with PTSD, depression, and anxiety. If you struggle getting along with coworkers or even friends and family, we can work to improve those relationships. Isolation does not fix the problem, it further damages those relationships and leaves you feeling alone. Anger and anxiety are natural feelings. However, sometimes controlling them can be easier said than done.
(304) 443-5587 View (304) 443-5587
1

See more therapy options for Charleston

How does your Therapist compare?

Number of Therapists in Charleston, WV

90+

Average cost per session

$150

Therapists in Charleston, WV who prioritize treating:

90% Anxiety
86% Depression
71% Grief
71% Coping Skills
69% Trauma and PTSD
69% Self Esteem
68% Relationship Issues

Average years in practice

13 Years

Top 3 insurances accepted

80% Aetna
73% BlueCross and BlueShield
70% UnitedHealthcare UHC | UBH

How Therapists in Charleston, WV see their clients

52% Online Only
48% In Person and Online

Gender breakdown

87% Female
13% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Charleston?

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.