Photo of Makeda Bostwick, LPC, Licensed Professional Counselor
Makeda Bostwick
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Pittsburgh, PA 15212  (Online Only)
In the journey to healing and self-discovery, each of us carries a unique tapestry of history, traumas, fears, and perspectives. Unbeknownst to us, our past experiences shape our views of self, others, and the world, influencing our communication, behavior, and relationships. My mission is to walk beside you, not ahead of you, on your path to healing. Together, we unravel unhelpful communication patterns, behaviors, and the impact of childhood programming. My focus is on helping you become aware of your needs and develop effective ways to communicate them.
In the journey to healing and self-discovery, each of us carries a unique tapestry of history, traumas, fears, and perspectives. Unbeknownst to us, our past experiences shape our views of self, others, and the world, influencing our communication, behavior, and relationships. My mission is to walk beside you, not ahead of you, on your path to healing. Together, we unravel unhelpful communication patterns, behaviors, and the impact of childhood programming. My focus is on helping you become aware of your needs and develop effective ways to communicate them.
(959) 210-6800 View (959) 210-6800
Photo of Dominique Flint - Free To Be Counseling Services, LLC, MSEd, LPC, CCTP, Licensed Professional Counselor
Free To Be Counseling Services, LLC
Licensed Professional Counselor, MSEd, LPC, CCTP
Verified Verified
Pittsburgh, PA 15212  (Online Only)
Hey, I’m Dominique! Are you struggling with anxiety? Do you feel overcome by fear, a lack of self-trust, and people pleasing? Do you feel misaligned in your life, wanting to be a good parent, partner, and friend but struggling to keep up? Are your relationships missing connection and vulnerability? Do you ever struggle to set boundaries with yourself and others? Well I see you! The struggle is real! I enjoy supporting Black women who believe they are ready to show up unapologetic. Those women who have finally decided they'd rather be honest because shame hasn't manifested a meaningful life. They are present and ready for change!
Hey, I’m Dominique! Are you struggling with anxiety? Do you feel overcome by fear, a lack of self-trust, and people pleasing? Do you feel misaligned in your life, wanting to be a good parent, partner, and friend but struggling to keep up? Are your relationships missing connection and vulnerability? Do you ever struggle to set boundaries with yourself and others? Well I see you! The struggle is real! I enjoy supporting Black women who believe they are ready to show up unapologetic. Those women who have finally decided they'd rather be honest because shame hasn't manifested a meaningful life. They are present and ready for change!
(484) 946-4521 View (484) 946-4521
Photo of Elizabeth Patterson, LCSW, CCTP, Clinical Social Work/Therapist
Elizabeth Patterson
Clinical Social Work/Therapist, LCSW, CCTP
Verified Verified
1 Endorsed
Pittsburgh, PA 15212  (Online Only)
I have a passion for working with young children and their caregivers, & teens and adults working through trauma, stress and generational cycles of abuse and neglect. I am also skilled and passionate about working with First Responder families (Police/Fire/EMS) who are often left unsupported as they manage trauma and occupational stress which affects all members of their families. My clients come to therapy to reflect on their lives and make connections between past experiences and present reactions. If you are seeking an approach that is nervous system informed, neurodiversity affirming, and nonjudgmental, I may be the right fit!
I have a passion for working with young children and their caregivers, & teens and adults working through trauma, stress and generational cycles of abuse and neglect. I am also skilled and passionate about working with First Responder families (Police/Fire/EMS) who are often left unsupported as they manage trauma and occupational stress which affects all members of their families. My clients come to therapy to reflect on their lives and make connections between past experiences and present reactions. If you are seeking an approach that is nervous system informed, neurodiversity affirming, and nonjudgmental, I may be the right fit!
(412) 314-2771 View (412) 314-2771
Photo of Larkin Berkley, MA, LPC, Licensed Professional Counselor
Larkin Berkley
Licensed Professional Counselor, MA, LPC
Verified Verified
3 Endorsed
Pittsburgh, PA 15212  (Online Only)
Not accepting new clients
Asking for help or support can be scary. Making that step to get therapy takes a great deal of strength. Therapy gives people the opportunity to develop effective and healthy responses to life's stressors. I work to create a safe holding environment to allow you to feel comfortable being yourself. I work with clients to help them develop awareness over their behaviors, thoughts, patterns, and feelings. I like to get to the source rather than just focus on the symptoms.
Asking for help or support can be scary. Making that step to get therapy takes a great deal of strength. Therapy gives people the opportunity to develop effective and healthy responses to life's stressors. I work to create a safe holding environment to allow you to feel comfortable being yourself. I work with clients to help them develop awareness over their behaviors, thoughts, patterns, and feelings. I like to get to the source rather than just focus on the symptoms.
(610) 580-2424 View (610) 580-2424
Photo of Tamera Guenther - Eagles Counseling, LLC, LCSW, Clinical Social Work/Therapist
Eagles Counseling, LLC
Clinical Social Work/Therapist, LCSW
Verified Verified
Pittsburgh, PA 15212
I am Tamera Guenther and I am a therapist at Eagles Counseling. Are you looking for an expert trauma therapist? Are you looking for a safe place to talk to someone? Are you struggling with anxiety or depression? Is your marriage falling apart? Does your child have behavioral problems? I am here to help. I am willing to meet you where you are at. I specialize in CBT, EMDR, and Internal Family Systems. I also provide therapy for grief, depression, anxiety, and stress. I provide individual therapy for adolescents and adults. I also do couples counseling and family counseling.
I am Tamera Guenther and I am a therapist at Eagles Counseling. Are you looking for an expert trauma therapist? Are you looking for a safe place to talk to someone? Are you struggling with anxiety or depression? Is your marriage falling apart? Does your child have behavioral problems? I am here to help. I am willing to meet you where you are at. I specialize in CBT, EMDR, and Internal Family Systems. I also provide therapy for grief, depression, anxiety, and stress. I provide individual therapy for adolescents and adults. I also do couples counseling and family counseling.
(412) 998-8799 View (412) 998-8799
Photo of Nathan Russell Earl, MS, LPC, NCC, Licensed Professional Counselor
Nathan Russell Earl
Licensed Professional Counselor, MS, LPC, NCC
Verified Verified
Pittsburgh, PA 15212  (Online Only)
As a Licensed Professional Counselor, I have worked with individuals struggling with a variety of issues, including depression, anxiety, anger, grief and addiction. I aim to create a safe, supportive environment for my clients to process their emotions, and to create positive change in their lives. I hope to help my clients gain a healthier relationship with themselves by challenging their critical self-talk. I have worked with may people who think and say harsh, or even cruel things to themselves; that they would never say to another person, or a friend.
As a Licensed Professional Counselor, I have worked with individuals struggling with a variety of issues, including depression, anxiety, anger, grief and addiction. I aim to create a safe, supportive environment for my clients to process their emotions, and to create positive change in their lives. I hope to help my clients gain a healthier relationship with themselves by challenging their critical self-talk. I have worked with may people who think and say harsh, or even cruel things to themselves; that they would never say to another person, or a friend.
(412) 301-9147 View (412) 301-9147
Photo of Lori M. Massarelli - Ascend Integrative Counseling & Holistic Wellness, LCSW, Clinical Social Work/Therapist
Ascend Integrative Counseling & Holistic Wellness
Clinical Social Work/Therapist, LCSW
Verified Verified
Pittsburgh, PA 15212
Things may get overwhelming and a person may need to explore ways to manage a particular stressor. Another may desire to work on long-term challenges, emotions, or relationship concerns. Ascend therapists have worked with children, adolescents, adults and the elderly in both medical and therapeutic settings in the Pittsburgh area, over the past 27 years. We utilize a strength-based perspective that recognizes and seeks to ignite the inner strength that each individual possesses. We customize and personalize your services to facilitate an increase in mood, functioning, and well-being; to take you to a higher level.
Things may get overwhelming and a person may need to explore ways to manage a particular stressor. Another may desire to work on long-term challenges, emotions, or relationship concerns. Ascend therapists have worked with children, adolescents, adults and the elderly in both medical and therapeutic settings in the Pittsburgh area, over the past 27 years. We utilize a strength-based perspective that recognizes and seeks to ignite the inner strength that each individual possesses. We customize and personalize your services to facilitate an increase in mood, functioning, and well-being; to take you to a higher level.
(412) 903-3244 View (412) 903-3244
Photo of Kathleen A Brenckle, MSW, LCSW, CST, CCTP, Clinical Social Work/Therapist
Kathleen A Brenckle
Clinical Social Work/Therapist, MSW, LCSW, CST, CCTP
Verified Verified
Pittsburgh, PA 15212
Do you feel invisible? Has life lost it's zest? Do you feel like you and your spouse can't communicate? Are you talking about the same things over and over again and not getting anywhere? It is never too late to look at areas of your life that create significant stress and make a change; or take a troubled relationship and turn it into a healthy, loving, supportive union. I have had great success helping individuals & couples identify and resolve persistent issues helping them live the life they want. My passion is to motivate you to realize your full potential and achieve your dreams.
Do you feel invisible? Has life lost it's zest? Do you feel like you and your spouse can't communicate? Are you talking about the same things over and over again and not getting anywhere? It is never too late to look at areas of your life that create significant stress and make a change; or take a troubled relationship and turn it into a healthy, loving, supportive union. I have had great success helping individuals & couples identify and resolve persistent issues helping them live the life they want. My passion is to motivate you to realize your full potential and achieve your dreams.
(724) 479-7929 View (724) 479-7929
Photo of Kurt Kumler - Cedar Avenue Psychotherapy, PhD, Psychologist
Cedar Avenue Psychotherapy
Psychologist, PhD
Verified Verified
Pittsburgh, PA 15212
We believe that psychological well-being and healing come from our ability to foster awareness, understanding, and acceptance of our experience of life as a whole. Talking with a therapist can help facilitate this kind of personal growth.
We believe that psychological well-being and healing come from our ability to foster awareness, understanding, and acceptance of our experience of life as a whole. Talking with a therapist can help facilitate this kind of personal growth.
(412) 515-3728 View (412) 515-3728
Photo of Allana Sleeth, LCSW, Clinical Social Work/Therapist
Allana Sleeth
Clinical Social Work/Therapist, LCSW
Verified Verified
Pittsburgh, PA 15212
Not accepting new clients
I have over a decade and a half of experience as a psychotherapist working mainly with adults. I depend on your needs to direct the type of way I work. I rely on using techniques and a therapeutic style that are compassionate, respectful, uniquely-tailored, and value the whole person. I have extensive experience working with individuals with a range of disorders and a range of symptoms such as those from depression, anxiety, psychosis, PTSD, OCD, bipolar, and ADHD. I look forward to focusing on ways to assist you in finding a more contented, self-accepting and peaceful life.
I have over a decade and a half of experience as a psychotherapist working mainly with adults. I depend on your needs to direct the type of way I work. I rely on using techniques and a therapeutic style that are compassionate, respectful, uniquely-tailored, and value the whole person. I have extensive experience working with individuals with a range of disorders and a range of symptoms such as those from depression, anxiety, psychosis, PTSD, OCD, bipolar, and ADHD. I look forward to focusing on ways to assist you in finding a more contented, self-accepting and peaceful life.
(412) 214-8936 View (412) 214-8936
Photo of Ivan Vega Pacheco, MA, LPC, NCC, CAADC, CCTP, Licensed Professional Counselor
Ivan Vega Pacheco
Licensed Professional Counselor, MA, LPC, NCC, CAADC, CCTP
Verified Verified
Pittsburgh, PA 15212  (Online Only)
Hello, I'm Ivan, a Licensed Professional Counselor with a dedicated focus on the integrative treatment of complex trauma and substance use disorders (SUD). My psychotherapy approach combines evidence-based techniques with a deep understanding of the unique challenges that come with these intertwined issues.
Hello, I'm Ivan, a Licensed Professional Counselor with a dedicated focus on the integrative treatment of complex trauma and substance use disorders (SUD). My psychotherapy approach combines evidence-based techniques with a deep understanding of the unique challenges that come with these intertwined issues.
(412) 284-5878 View (412) 284-5878
Photo of Julisa Holmes, MS, LPC, LMHC, NCC, Licensed Professional Counselor
Julisa Holmes
Licensed Professional Counselor, MS, LPC, LMHC, NCC
Verified Verified
1 Endorsed
Pittsburgh, PA 15212  (Online Only)
Hi! My name is Julisa. As a Philadelphia native and person of color, I am driven by my desire to provide healthy representation of breaking generational trauma I longed to see available for myself and loved ones during various trials in our lives. I’ve used my wealth of professional and personal experience in community behavioral health and private practice settings to work as a team with people that are trying to create senses of stability, fulfillment and self-understanding in their lives. I aim to get rid of stigmas related to seeking professional help. Everyone deserves access to meaningful ways of healing without being labeled.
Hi! My name is Julisa. As a Philadelphia native and person of color, I am driven by my desire to provide healthy representation of breaking generational trauma I longed to see available for myself and loved ones during various trials in our lives. I’ve used my wealth of professional and personal experience in community behavioral health and private practice settings to work as a team with people that are trying to create senses of stability, fulfillment and self-understanding in their lives. I aim to get rid of stigmas related to seeking professional help. Everyone deserves access to meaningful ways of healing without being labeled.
(412) 365-4590 View (412) 365-4590
Photo of Julie Saragosa, MC, Pre-Licensed Professional
Julie Saragosa
Pre-Licensed Professional, MC
Verified Verified
Pittsburgh, PA 15212
As your therapist, my goal is to provide a comfortable and safe environment for you to express your feelings and help you gain perspective with challenges you may be facing. My clients learn healthy coping skills and tools to better navigate life's difficult moments. My role is to walk alongside you through this journey to your most empowered and best self. By challenging beliefs and emotions that no longer serve you, in addition to improving intra and interpersonal relationships, personal growth and symptom relief are my goals for you. You are not alone; allow me to help you through challenges and find hope and happiness again.
As your therapist, my goal is to provide a comfortable and safe environment for you to express your feelings and help you gain perspective with challenges you may be facing. My clients learn healthy coping skills and tools to better navigate life's difficult moments. My role is to walk alongside you through this journey to your most empowered and best self. By challenging beliefs and emotions that no longer serve you, in addition to improving intra and interpersonal relationships, personal growth and symptom relief are my goals for you. You are not alone; allow me to help you through challenges and find hope and happiness again.
(412) 816-8923 View (412) 816-8923
Photo of Fabyonne Williams, EdD, MS, MA, LPC, MFT, Licensed Professional Counselor
Fabyonne Williams
Licensed Professional Counselor, EdD, MS, MA, LPC, MFT
Verified Verified
Pittsburgh, PA 15212  (Online Only)
We live such hectic and often overwhelming lives that counseling provides us the opportunity to check out, even if only for a moment. Granting individuals a listening ear and a compassionate empathetic response is my specialty. My ultimate goal is to build healthy individuals and families by developing the therapeutic tool box filled with practices that bring calm to chaos. We must look to our foundation and past experiences in order to create a plan for healing and future success. With that, much of our work will involve delving deep into Family of Origin issues in order to create healthy new norms and patterns.
We live such hectic and often overwhelming lives that counseling provides us the opportunity to check out, even if only for a moment. Granting individuals a listening ear and a compassionate empathetic response is my specialty. My ultimate goal is to build healthy individuals and families by developing the therapeutic tool box filled with practices that bring calm to chaos. We must look to our foundation and past experiences in order to create a plan for healing and future success. With that, much of our work will involve delving deep into Family of Origin issues in order to create healthy new norms and patterns.
(412) 900-8791 View (412) 900-8791
Photo of Debra M Whittam, LPC, MSEd, CCDPD, CAADC, Licensed Professional Counselor
Debra M Whittam
Licensed Professional Counselor, LPC, MSEd, CCDPD, CAADC
Verified Verified
1 Endorsed
Pittsburgh, PA 15212
My ideal clients have issues with anxiety, depression, addiction and grief. Those who have little to no family support or friend network to rely on during difficult times. I work with people who struggle with alcoholism and drug abuse and repeated relapse. I also specialize in Adult Children of Alcoholism or Dysfunctional Homes. Many of my clients need help making life decisions especially between the ages of 16-26. Also those who are in transition either from divorce, from college to the workplace and single parents. Most everyone needs to know if they are going to be okay and if they are, how will they be okay.
My ideal clients have issues with anxiety, depression, addiction and grief. Those who have little to no family support or friend network to rely on during difficult times. I work with people who struggle with alcoholism and drug abuse and repeated relapse. I also specialize in Adult Children of Alcoholism or Dysfunctional Homes. Many of my clients need help making life decisions especially between the ages of 16-26. Also those who are in transition either from divorce, from college to the workplace and single parents. Most everyone needs to know if they are going to be okay and if they are, how will they be okay.
(412) 467-0492 View (412) 467-0492
Photo of Ryan Mest Phd, PhD, Psychologist
Ryan Mest Phd
Psychologist, PhD
Verified Verified
Pittsburgh, PA 15212  (Online Only)
I work with people who are stuck in a feeling, thought, or behavior with no room for other feelings, other thoughts, or contact with others beyond what they are stuck with. I work with people experiencing something painful and curious that they know is coming from them but it's as if it is happening to them. In other words, something like a painful dream, which I know is coming from me but it's as if it's happening to me. I work with people who feel enough security in our relationship to be able to talk about our relationship. The arts and humanities have been a fixture of my professional life in addition to being a psychologist.
I work with people who are stuck in a feeling, thought, or behavior with no room for other feelings, other thoughts, or contact with others beyond what they are stuck with. I work with people experiencing something painful and curious that they know is coming from them but it's as if it is happening to them. In other words, something like a painful dream, which I know is coming from me but it's as if it's happening to me. I work with people who feel enough security in our relationship to be able to talk about our relationship. The arts and humanities have been a fixture of my professional life in addition to being a psychologist.
(412) 424-7404 View (412) 424-7404
Photo of Danica Nichols, LPC, Licensed Professional Counselor
Danica Nichols
Licensed Professional Counselor, LPC
Verified Verified
Pittsburgh, PA 15212  (Online Only)
Hi there, I am Danica, a Licensed Professional Counselor with over 17 years of experience in the mental health and addiction field. My approach is warm, compassionate and supportive in a comfortable nonjudgmental environment. I have experience in helping clients with stress and anxiety, trauma, military, depression, addiction, bipolar and others.
Hi there, I am Danica, a Licensed Professional Counselor with over 17 years of experience in the mental health and addiction field. My approach is warm, compassionate and supportive in a comfortable nonjudgmental environment. I have experience in helping clients with stress and anxiety, trauma, military, depression, addiction, bipolar and others.
(412) 990-2523 View (412) 990-2523
Photo of Rachel Ashbaugh, LPC, Licensed Professional Counselor
Rachel Ashbaugh
Licensed Professional Counselor, LPC
Verified Verified
Pittsburgh, PA 15212  (Online Only)
Are you uncomfortable with yourself, unhappy with the choices you make and the situations you put yourself in?
Are you uncomfortable with yourself, unhappy with the choices you make and the situations you put yourself in?
(412) 516-3291 View (412) 516-3291
Photo of Mikki Burgess, LPC, Licensed Professional Counselor
Mikki Burgess
Licensed Professional Counselor, LPC
Verified Verified
Pittsburgh, PA 15212  (Online Only)
Are you struggling with depression, anxiety, relationship issues or current stressors and want to navigate life’s stressors from a Christian worldview? If so, I am here to help!
Are you struggling with depression, anxiety, relationship issues or current stressors and want to navigate life’s stressors from a Christian worldview? If so, I am here to help!
(412) 435-3930 View (412) 435-3930
Photo of Zandra Robinson, LPC, Licensed Professional Counselor
Zandra Robinson
Licensed Professional Counselor, LPC
Verified Verified
Pittsburgh, PA 15212
I am a licensed therapist in Pennsylvania with 10 years of professional therapeutic experience. I have experience in helping clients with stress and anxiety, relationship issues, family conflicts, & parenting issues. I believe that you are the expert of your story and that you have many strengths that will assist you in overcoming things that challenge you. Taking the first step to seek a more fulfilling and happier life takes courage. I am here to support you in that process.
I am a licensed therapist in Pennsylvania with 10 years of professional therapeutic experience. I have experience in helping clients with stress and anxiety, relationship issues, family conflicts, & parenting issues. I believe that you are the expert of your story and that you have many strengths that will assist you in overcoming things that challenge you. Taking the first step to seek a more fulfilling and happier life takes courage. I am here to support you in that process.
(412) 534-5611 View (412) 534-5611
1

How does your Therapist compare?

Number of Therapists in 15212

100+

Average cost per session

$107

Therapists in 15212 who prioritize treating:

95% Anxiety
87% Depression
78% Self Esteem
74% Coping Skills
60% Trauma and PTSD
57% Grief
52% Relationship Issues

Average years in practice

11 Years

Top 3 insurances accepted

92% Aetna
87% Cigna and Evernorth
84% UnitedHealthcare UHC | UBH

How Therapists in 15212 see their clients

64% Online Only
36% In Person and Online

Gender breakdown

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

How can I find a therapist in 15212?

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.