Therapists in Ramsey, NJ

Photo of Dr. Jennifer Politis, PhD, LPC, SchPsy, ACS, Licensed Professional Counselor
Dr. Jennifer Politis
Licensed Professional Counselor, PhD, LPC, SchPsy, ACS
Verified Verified
3 Endorsed
Ramsey, NJ 07446
Are you looking for more fulfilling relationships in your life? Do you want to regain balance and have less anxiety? Are you worried about your child and want them to have more confidence, perform better in school and be more prepared for the world around them? I help you feel more fulfilled in your job, family life and relationships. I help you sort through your feelings and find the barriers in your life holding you back. Identifing the patterns from your childhood that creep into your everyday interactions are a focus so they aren't a driving force anymore and you are more self aware.
Are you looking for more fulfilling relationships in your life? Do you want to regain balance and have less anxiety? Are you worried about your child and want them to have more confidence, perform better in school and be more prepared for the world around them? I help you feel more fulfilled in your job, family life and relationships. I help you sort through your feelings and find the barriers in your life holding you back. Identifing the patterns from your childhood that creep into your everyday interactions are a focus so they aren't a driving force anymore and you are more self aware.
(551) 266-5518 View (551) 266-5518
Photo of Ezra Cowan - The Center for OCD, PsyD, Psychologist
The Center for OCD
Psychologist, PsyD
Verified Verified
1 Endorsed
Ramsey, NJ 07446
Are you tired of avoiding and performing frustrating rituals to reduce anxiety and uncertainty? Do you find yourself stuck and unable to move on from unwanted scary thoughts? Are you ready and eager to live a much more flexible, relaxed, and connected life?
Are you tired of avoiding and performing frustrating rituals to reduce anxiety and uncertainty? Do you find yourself stuck and unable to move on from unwanted scary thoughts? Are you ready and eager to live a much more flexible, relaxed, and connected life?
(201) 298-7861 View (201) 298-7861
Photo of Colleen Amundson, MS, NCC, LPC, Licensed Professional Counselor
Colleen Amundson
Licensed Professional Counselor, MS, NCC, LPC
Verified Verified
1 Endorsed
Ramsey, NJ 07446
Therapy can be intimidating and scary. Therapy can also be an amazing adventure full of wonderful insight and inspirational growth. As a Licensed Professional Counselor in NJ and PA with a decade of experience I provide therapeutic services to young adults and adults ages 18 and up. I have experience with anxiety, depression, trauma, grief, ADHD, ODD, and anger management. I am certified in telemedicine counseling, anxiety treatment, and dialectical behavior therapy. I am an ally to all and provide judgement free therapy. Currently accepting Aetna, BCBS, Cigna, Oxford, and United health insurance in NJ. BCBS and Aetna in PA.
Therapy can be intimidating and scary. Therapy can also be an amazing adventure full of wonderful insight and inspirational growth. As a Licensed Professional Counselor in NJ and PA with a decade of experience I provide therapeutic services to young adults and adults ages 18 and up. I have experience with anxiety, depression, trauma, grief, ADHD, ODD, and anger management. I am certified in telemedicine counseling, anxiety treatment, and dialectical behavior therapy. I am an ally to all and provide judgement free therapy. Currently accepting Aetna, BCBS, Cigna, Oxford, and United health insurance in NJ. BCBS and Aetna in PA.
(201) 379-2850 View (201) 379-2850
Photo of John J. Selleck, MSW, LCSW, Clinical Social Work/Therapist
John J. Selleck
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
1 Endorsed
Ramsey, NJ 07446
Feeling connected to and understood provides the foundation for any healthy relationship, including the therapeutic relationship. It is my goal to provide a supportive, trusting and non-judgmental environment in order to foster greater self-awareness, insight and personal growth and fulfillment. One parent of a 13-year old client said: "During one of the darkest and most difficult times in our lives, in you came ready to listen, guide, support, and be a beacon of light in an otherwise dark time. My son immediately felt safe with you and trusted you. That is a true gift and says so much about you both personally and professionally."
Feeling connected to and understood provides the foundation for any healthy relationship, including the therapeutic relationship. It is my goal to provide a supportive, trusting and non-judgmental environment in order to foster greater self-awareness, insight and personal growth and fulfillment. One parent of a 13-year old client said: "During one of the darkest and most difficult times in our lives, in you came ready to listen, guide, support, and be a beacon of light in an otherwise dark time. My son immediately felt safe with you and trusted you. That is a true gift and says so much about you both personally and professionally."
(201) 379-2268 View (201) 379-2268
Photo of Jill Essery, LCSW, LLC, Clinical Social Work/Therapist
Jill Essery
Clinical Social Work/Therapist, LCSW, LLC
Verified Verified
Ramsey, NJ 07446
Many of my clients find themselves overwhelmed by anxiety, depression, or stress, often because their personal boundaries are unclear or too flexible. Together, we can explore the challenges in your life that may be affecting your emotional well-being. By gaining a deeper understanding of these experiences, we can identify where boundaries might need to be reinforced or redefined. I’m here to support you in establishing healthier dynamics that allow you to better manage your emotions, reduce stress, and build more fulfilling relationships.
Many of my clients find themselves overwhelmed by anxiety, depression, or stress, often because their personal boundaries are unclear or too flexible. Together, we can explore the challenges in your life that may be affecting your emotional well-being. By gaining a deeper understanding of these experiences, we can identify where boundaries might need to be reinforced or redefined. I’m here to support you in establishing healthier dynamics that allow you to better manage your emotions, reduce stress, and build more fulfilling relationships.
(917) 722-8665 View (917) 722-8665
Photo of Laura Porcaro, LCSW, R, Clinical Social Work/Therapist
Laura Porcaro
Clinical Social Work/Therapist, LCSW, R
Verified Verified
Ramsey, NJ 07446
Each person looking for a therapist has their own reasons. Some look for support during a life crisis others choose to look at their life and their relationships. I employ concrete solution based methods in order to help my clients learn about themselves and communicate more effectively with others. In an atmosphere that is safe and supportive, clients can express themselves fully without the fear of judgement.
Each person looking for a therapist has their own reasons. Some look for support during a life crisis others choose to look at their life and their relationships. I employ concrete solution based methods in order to help my clients learn about themselves and communicate more effectively with others. In an atmosphere that is safe and supportive, clients can express themselves fully without the fear of judgement.
(201) 468-6657 View (201) 468-6657
Raffaela Bartels
Licensed Professional Counselor, MA, LPC, ACS
Verified Verified
Ramsey, NJ 07446
Waitlist for new clients
I am a Licensed Professional Counselor with over 20 years of experience working with children, adolescents, families and adults. I have worked with people to find coping skills, ways to decrease depression and anxiety, couples counseling and family counseling. I am also an approved clinical supervisor (ACS) for those who may need supervision to achieve their LPC.
I am a Licensed Professional Counselor with over 20 years of experience working with children, adolescents, families and adults. I have worked with people to find coping skills, ways to decrease depression and anxiety, couples counseling and family counseling. I am also an approved clinical supervisor (ACS) for those who may need supervision to achieve their LPC.
(551) 210-9180 View (551) 210-9180
Photo of Lana Tiersky - Bergen Psychotherapy & Neuropsychology, Inc., PhD, Psychologist
Bergen Psychotherapy & Neuropsychology, Inc.
Psychologist, PhD
Verified Verified
Ramsey, NJ 07446
Waitlist for new clients
Please note, I am only taking patients affected by the current war in Israel. I am doing this as a community service. As a PhD Clinical Psychologist for over 25 years, I have worked with a wide range of patients including executives, veterans, students and parents. While everyone is unique, my approach to treatment generally focuses on helping the patient understand the connections between their thoughts, feelings and behaviors so that they ultimately can gain better control over all of them and find the personal meaning in their life.
Please note, I am only taking patients affected by the current war in Israel. I am doing this as a community service. As a PhD Clinical Psychologist for over 25 years, I have worked with a wide range of patients including executives, veterans, students and parents. While everyone is unique, my approach to treatment generally focuses on helping the patient understand the connections between their thoughts, feelings and behaviors so that they ultimately can gain better control over all of them and find the personal meaning in their life.
View
Photo of Frank Anthony Vecchiano, MS, LMHC, NCC, CASAC, Counselor
Frank Anthony Vecchiano
Counselor, MS, LMHC, NCC, CASAC
Verified Verified
Ramsey, NJ 07446
Though change may be difficult, I believe everyone is capable of making positive changes in their life. It is a matter of finding the right direction and guidance to getting there. I am a licensed mental health counselor and certified alcohol and substance abuse counselor with 10 years of experience, helping adult clients to achieve recovery and improve their overall quality of life. My primary focus includes treatment for people who are experiencing substance abuse, gambling, depression, and anxiety issues. The goal of therapy is to better understand how your emotions, thinking and behavior is impacting your life.
Though change may be difficult, I believe everyone is capable of making positive changes in their life. It is a matter of finding the right direction and guidance to getting there. I am a licensed mental health counselor and certified alcohol and substance abuse counselor with 10 years of experience, helping adult clients to achieve recovery and improve their overall quality of life. My primary focus includes treatment for people who are experiencing substance abuse, gambling, depression, and anxiety issues. The goal of therapy is to better understand how your emotions, thinking and behavior is impacting your life.
(201) 584-8252 View (201) 584-8252
Photo of Tina M Pisani - Embodied Healing, LLC, MA, NCC, LPC, Licensed Professional Counselor
Embodied Healing, LLC
Licensed Professional Counselor, MA, NCC, LPC
Verified Verified
Ramsey, NJ 07446  (Online Only)
Come as you are and begin your unique process to embody healing. By providing a safe, compassionate, and warm environment, I believe I meet my clients in a space of empathy which enables them to cultivate meaningful change in their lives.
Come as you are and begin your unique process to embody healing. By providing a safe, compassionate, and warm environment, I believe I meet my clients in a space of empathy which enables them to cultivate meaningful change in their lives.
(201) 419-6561 View (201) 419-6561
Photo of Eugene Dunaev - Positive Living Psychological Services, LLC, PsyD, Psychologist
Positive Living Psychological Services, LLC
Psychologist, PsyD
Verified Verified
Ramsey, NJ 07446
I believe that therapy is an opportunity for people to get the most out of life. It is a reflection of one’s courage to face familial changes, life stressors and significant emotional experiences. An overarching goal of my practice is to utilize one’s talents, strengths, creativity, wisdom and optimism to help individuals regain control of their complicated lives. As such, I utilize Cognitive Behavioral and Psychodynamic approaches. I find that Psychodynamic Therapy can be particularly beneficial for those who have lost meaning in their lives or have difficulty forming or maintaining relationships.
I believe that therapy is an opportunity for people to get the most out of life. It is a reflection of one’s courage to face familial changes, life stressors and significant emotional experiences. An overarching goal of my practice is to utilize one’s talents, strengths, creativity, wisdom and optimism to help individuals regain control of their complicated lives. As such, I utilize Cognitive Behavioral and Psychodynamic approaches. I find that Psychodynamic Therapy can be particularly beneficial for those who have lost meaning in their lives or have difficulty forming or maintaining relationships.
(551) 210-9163 View (551) 210-9163
Photo of Courtney Hulse, LMFT, Marriage & Family Therapist
Courtney Hulse
Marriage & Family Therapist, LMFT
Verified Verified
1 Endorsed
Ramsey, NJ 07446
Alcohol and Drug addiction impact millions of lives a year, but it is time to reclaim yours. Over the past decade, I have enjoyed working with individuals and families on their journey toward reaching their recovery goals. In our clinical sessions, I will help you achieve self-awareness and holistic healing through psychoeducation as well as mind-body techniques. As Mountainside Ramsey's Outpatient Services Program Manager, I will draw from my years of clinical practice in treating substance use and mental health disorders to create an individualized treatment plan tailored to your needs.
Alcohol and Drug addiction impact millions of lives a year, but it is time to reclaim yours. Over the past decade, I have enjoyed working with individuals and families on their journey toward reaching their recovery goals. In our clinical sessions, I will help you achieve self-awareness and holistic healing through psychoeducation as well as mind-body techniques. As Mountainside Ramsey's Outpatient Services Program Manager, I will draw from my years of clinical practice in treating substance use and mental health disorders to create an individualized treatment plan tailored to your needs.
(551) 363-2886 View (551) 363-2886
Photo of Michelle Y Pearlman, PhD, Psychologist
Michelle Y Pearlman
Psychologist, PhD
Verified Verified
Ramsey, NJ 07446
I work with people of all ages to face challenges and conquer difficulties in a warm and supportive environment. I have over twenty years of experience helping people feel less anxious, sad, and alone, and more capable and empowered to live their best lives. I specialize in cognitive behavioral therapy (CBT), which is a therapeutic approach proven effective in the treatment of a wide range of problems, from anxiety, depression and trauma to children’s behavior and positive parenting. If you are struggling, or simply want to handle life and stress more effectively, I am here to help. Together, we can work to create lasting change.
I work with people of all ages to face challenges and conquer difficulties in a warm and supportive environment. I have over twenty years of experience helping people feel less anxious, sad, and alone, and more capable and empowered to live their best lives. I specialize in cognitive behavioral therapy (CBT), which is a therapeutic approach proven effective in the treatment of a wide range of problems, from anxiety, depression and trauma to children’s behavior and positive parenting. If you are struggling, or simply want to handle life and stress more effectively, I am here to help. Together, we can work to create lasting change.
(201) 639-8779 View (201) 639-8779
Photo of Shmuel Skaist, MS, LPC, CSAT-c, Licensed Professional Counselor
Shmuel Skaist
Licensed Professional Counselor, MS, LPC, CSAT-c
Verified Verified
1 Endorsed
Ramsey, NJ 07446
My goal as a therapist is to help you learn skills for leading a more fulfilling and functional reality and to help you on your way to living your best life. I use an empathetic and individualized approach to help people of all backgrounds navigate life issues and stressors and make positive and meaningful changes. I work with individuals, couples, and adolescents on relationships, intimacy, parenting, life transitions, self-esteem, childhood traumas, traumatic events, and anxiety. If you need help realizing your full potential, I'll help you identify your obstacles and how to navigate them.
My goal as a therapist is to help you learn skills for leading a more fulfilling and functional reality and to help you on your way to living your best life. I use an empathetic and individualized approach to help people of all backgrounds navigate life issues and stressors and make positive and meaningful changes. I work with individuals, couples, and adolescents on relationships, intimacy, parenting, life transitions, self-esteem, childhood traumas, traumatic events, and anxiety. If you need help realizing your full potential, I'll help you identify your obstacles and how to navigate them.
(845) 552-2431 View (845) 552-2431
Photo of Amy-Leigh O'Rourke, LCSW, LCDAC, Drug & Alcohol Counselor
Amy-Leigh O'Rourke
Drug & Alcohol Counselor, LCSW, LCDAC
Verified Verified
Ramsey, NJ 07446
I am a Licensed Clinical Social Worker and Licensed Clinical Drug and Alcohol Counselor. As the Program Manager at the Ramsey location, I provide best-in-class care to clients and support to my exceptional team. With several years of experience working with those impacted by substance use, I am committed to raising the standard for quality, holistic, addiction treatment. Using an eclectic mix of evidence and research-based modalities, I prioritize creating a supportive environment that empowers clients on their unique paths to recovery. Outside of work, I enjoy traveling, discovering new music, and snuggling with my dog, Lenny.
I am a Licensed Clinical Social Worker and Licensed Clinical Drug and Alcohol Counselor. As the Program Manager at the Ramsey location, I provide best-in-class care to clients and support to my exceptional team. With several years of experience working with those impacted by substance use, I am committed to raising the standard for quality, holistic, addiction treatment. Using an eclectic mix of evidence and research-based modalities, I prioritize creating a supportive environment that empowers clients on their unique paths to recovery. Outside of work, I enjoy traveling, discovering new music, and snuggling with my dog, Lenny.
(551) 305-3165 View (551) 305-3165
Photo of Kathleen Ray, PhD, LCSW, Clinical Social Work/Therapist
Kathleen Ray
Clinical Social Work/Therapist, PhD, LCSW
Verified Verified
Ramsey, NJ 07446
I work with individuals, families, and couples around life transitions. I specialize in treating teenagers and young adults struggling with depression, anxiety, preparation for college, participating in high levels sports and relationship issues.
I work with individuals, families, and couples around life transitions. I specialize in treating teenagers and young adults struggling with depression, anxiety, preparation for college, participating in high levels sports and relationship issues.
(201) 809-9457 View (201) 809-9457
Photo of Dr. Valerie Wood, LCSW, LCADC, Clinical Social Work/Therapist
Dr. Valerie Wood
Clinical Social Work/Therapist, LCSW, LCADC
Verified Verified
Ramsey, NJ 07446  (Online Only)
I work with individuals who struggle with challenges associated with eating, alcohol, prescription medication and mental health issues. If you have struggled with substances or believe you may have an addiction; have problems with eating whether binging, bulimia, have had or are thinking of weight loss surgery*; and/or if you suffer from a mood disorder, I may be able to provide tools to support you in facilitating balance in mind, body and spirit. *Weight loss surgery is a specialty as I have been working in this field since 2001. I am certified in Telebehavioral Health and practice is HIPAA compliant.
I work with individuals who struggle with challenges associated with eating, alcohol, prescription medication and mental health issues. If you have struggled with substances or believe you may have an addiction; have problems with eating whether binging, bulimia, have had or are thinking of weight loss surgery*; and/or if you suffer from a mood disorder, I may be able to provide tools to support you in facilitating balance in mind, body and spirit. *Weight loss surgery is a specialty as I have been working in this field since 2001. I am certified in Telebehavioral Health and practice is HIPAA compliant.
(551) 209-2250 View (551) 209-2250
Photo of Mara Zotta, PsyD, Psychologist
Mara Zotta
Psychologist, PsyD
Verified Verified
Ramsey, NJ 07446
I am a Licensed Psychologist working with children, adolescents and adults who are experiencing difficult life changes and stages. I work within a psychodynamic framework and I am interactive. I believe that to make changes today we need to explore the past to gain better understanding of ourselves. I encourage the exploration of relationships within the cultural context. I work with children, adolescents and adults with relationship issues, anxiety, depression, stress, family issues, and career issues.
I am a Licensed Psychologist working with children, adolescents and adults who are experiencing difficult life changes and stages. I work within a psychodynamic framework and I am interactive. I believe that to make changes today we need to explore the past to gain better understanding of ourselves. I encourage the exploration of relationships within the cultural context. I work with children, adolescents and adults with relationship issues, anxiety, depression, stress, family issues, and career issues.
(551) 333-5947 View (551) 333-5947
Photo of James V. Nono, LCSW, LCADC, Clinical Social Work/Therapist
James V. Nono
Clinical Social Work/Therapist, LCSW, LCADC
Verified Verified
1 Endorsed
Ramsey, NJ 07446
Hi! I’m James. Life’s challenges and transitions can be extremely difficult to navigate, but with your commitment to your mental health and overall well-being, we can collaboratively work to find happiness and meaning in your life. I would be happy to assist you in creating coping skills and strategies that will work for you in developing a greater sense of self. As a Licensed Clinical Social Worker and Therapist, I am knowledgeable and skilled in working with a variety of issues such as addiction, relationship issues, anxiety and depression, self-esteem, finding purpose and meaning, and major life transitions.
Hi! I’m James. Life’s challenges and transitions can be extremely difficult to navigate, but with your commitment to your mental health and overall well-being, we can collaboratively work to find happiness and meaning in your life. I would be happy to assist you in creating coping skills and strategies that will work for you in developing a greater sense of self. As a Licensed Clinical Social Worker and Therapist, I am knowledgeable and skilled in working with a variety of issues such as addiction, relationship issues, anxiety and depression, self-esteem, finding purpose and meaning, and major life transitions.
(201) 574-7146 View (201) 574-7146
Photo of Dr. Kirsten E Petersen, PhD, Psychologist
Dr. Kirsten E Petersen
Psychologist, PhD
Verified Verified
Ramsey, NJ 07446  (Online Only)
Life can be overwhelming. Stress, worry, sadness, and loneliness. All are painful feelings that can undermine your self-confidence and leave you feeling helpless and hopeless. I'm here to help you face your challenges and get back your sense of control and peace of mind.
Life can be overwhelming. Stress, worry, sadness, and loneliness. All are painful feelings that can undermine your self-confidence and leave you feeling helpless and hopeless. I'm here to help you face your challenges and get back your sense of control and peace of mind.
(551) 525-2968 View (551) 525-2968
1

How does your Therapist compare?

Number of Therapists in Ramsey, NJ

100+

Average cost per session

$185

Therapists in Ramsey, NJ who prioritize treating:

95% Anxiety
87% Relationship Issues
87% Depression
84% Self Esteem
72% Coping Skills
70% Stress
65% Trauma and PTSD

Average years in practice

15 Years

Top 3 insurances accepted

77% Aetna
65% UnitedHealthcare UHC | UBH
58% Cigna and Evernorth

How Therapists in Ramsey, NJ see their clients

87% In Person and Online
13% Online Only

Gender breakdown

78% Female
21% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Ramsey?

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.