Therapists in 19123
Al Fernandes
Clinical Social Work/Therapist, LSW
Verified Verified
1 Endorsed
Philadelphia, PA 19123
Hi, I’m Al (she/her he/him). When we take time to slow down and give our pain attention, we make meaning out of our struggles and experience healing. I love this process, it's engaging, but more importantly it’s an opportunity to resist oppressive forces by offering ourselves love and space. Using various methods, we can: carefully explore grief and trauma; pull apart shame, and be present for parts of you that deserve compassion; empower you over oppressive systems; make room for more pleasure and joy; relate to others differently, more deeply, or more often; affirm who you are, and find gratitude for what you’ve learned.
Hi, I’m Al (she/her he/him). When we take time to slow down and give our pain attention, we make meaning out of our struggles and experience healing. I love this process, it's engaging, but more importantly it’s an opportunity to resist oppressive forces by offering ourselves love and space. Using various methods, we can: carefully explore grief and trauma; pull apart shame, and be present for parts of you that deserve compassion; empower you over oppressive systems; make room for more pleasure and joy; relate to others differently, more deeply, or more often; affirm who you are, and find gratitude for what you’ve learned.
Are you navigating a difficult time in your life? You deserve a space where you feel truly understood, supported, and empowered. In our work together, we'll focus on building resilience, finding balance, and developing a stronger sense of self. We’ll explore effective strategies to manage life's stressors and cope with anxiety and trauma. My approach to therapy is compassionate and tailored, respecting your unique experiences while promoting growth and healing. Providing warmth and empathy, I ensure you feel safe and heard. Together, we can uncover your strengths and build renewed hope and purpose.
Are you navigating a difficult time in your life? You deserve a space where you feel truly understood, supported, and empowered. In our work together, we'll focus on building resilience, finding balance, and developing a stronger sense of self. We’ll explore effective strategies to manage life's stressors and cope with anxiety and trauma. My approach to therapy is compassionate and tailored, respecting your unique experiences while promoting growth and healing. Providing warmth and empathy, I ensure you feel safe and heard. Together, we can uncover your strengths and build renewed hope and purpose.
Loran Grishow-Schade
Clinical Social Work/Therapist, LSW
Verified Verified
1 Endorsed
Philadelphia, PA 19123 (Online Only)
If you're overwhelmed by societal expectations and questioning your place—what it means to fit into specific roles or identities—you're not alone. Many of us are trying to understand our emotions, eager for personal growth, and seeking genuine connections that resonate with our values. You may be looking for ways to confidently engage in sensitive conversations, aiming to influence change positively and achieve a balance that reflects your true self. Your goals likely extend beyond overcoming these challenges; you aspire to thrive, becoming a more engaged individual who shapes the changes you desire in the world.
If you're overwhelmed by societal expectations and questioning your place—what it means to fit into specific roles or identities—you're not alone. Many of us are trying to understand our emotions, eager for personal growth, and seeking genuine connections that resonate with our values. You may be looking for ways to confidently engage in sensitive conversations, aiming to influence change positively and achieve a balance that reflects your true self. Your goals likely extend beyond overcoming these challenges; you aspire to thrive, becoming a more engaged individual who shapes the changes you desire in the world.
Ayla Fleming
Clinical Social Work/Therapist, LCSW, LCADC, CCS, EMDR-T, CRP
Verified Verified
Philadelphia, PA 19123 (Online Only)
My style is relaxed, with a healthy dose of humor, warmth, and calm. I work with individuals and couples struggling with family, employment, or career dynamics. You may want to reduce people-pleasing behaviors, establish boundaries, or discern whether a relationship is healthy or not. Anxiety, burnout, resentment, anger, and depression are indicators that something needs to be discussed. I also have experience with families with addiction and mental health issues. You can learn to set limits where you previously felt guilty or fearful to do so. I often work with helpers such as medical field, law enforcement, lawyers, and veterans.
My style is relaxed, with a healthy dose of humor, warmth, and calm. I work with individuals and couples struggling with family, employment, or career dynamics. You may want to reduce people-pleasing behaviors, establish boundaries, or discern whether a relationship is healthy or not. Anxiety, burnout, resentment, anger, and depression are indicators that something needs to be discussed. I also have experience with families with addiction and mental health issues. You can learn to set limits where you previously felt guilty or fearful to do so. I often work with helpers such as medical field, law enforcement, lawyers, and veterans.
Shayan Salar
Clinical Social Work/Therapist, MSW, LCSW, LCADC
Verified Verified
1 Endorsed
Philadelphia, PA 19123 (Online Only)
People are so sick of holding their tongue, wearing costumes, and being inauthentic when navigating social relations. To me, therapy is a place to say the thing and acknowledge the parts of us that many won’t see or hear. The freedom that follows from that experience alone can make all the difference. My hope for our therapeutic relationship is to make space for all of that and more.
People are so sick of holding their tongue, wearing costumes, and being inauthentic when navigating social relations. To me, therapy is a place to say the thing and acknowledge the parts of us that many won’t see or hear. The freedom that follows from that experience alone can make all the difference. My hope for our therapeutic relationship is to make space for all of that and more.
Full Being Services
Licensed Professional Counselor, LPC, DAAETS
Verified Verified
Philadelphia, PA 19123
Whether you are experiencing life transitions, a family crisis, or have a diagnosable mental health concern, the Full Being team is here to support. We provide comprehensive wellness care in a culturally responsive manner. Often time clinicians may just focus on the cognitive, or the emotional. We believe in a holistic concept; working with you to support your growth and address your needs in the mind, body and spirit. Our clinicians have training in Cognitive Behavioral Therapy (CBT), Motivational Interviewing (MI), Trauma-Focused CBT, Mindfulness, and more. Services offered include individual, family & couples sessions.
Whether you are experiencing life transitions, a family crisis, or have a diagnosable mental health concern, the Full Being team is here to support. We provide comprehensive wellness care in a culturally responsive manner. Often time clinicians may just focus on the cognitive, or the emotional. We believe in a holistic concept; working with you to support your growth and address your needs in the mind, body and spirit. Our clinicians have training in Cognitive Behavioral Therapy (CBT), Motivational Interviewing (MI), Trauma-Focused CBT, Mindfulness, and more. Services offered include individual, family & couples sessions.
Mackenzie Stocum
Pre-Licensed Professional, MS, NCC, LAPC
Verified Verified
3 Endorsed
Philadelphia, PA 19123 (Online Only)
Do you feel lost or overwhelmed about the direction of your life, relationships, or the state of the world? Is uncertainty or hopelessness making it hard to stay present and engaged? Is your connection with yourself and others suffering because of it? If you sense a need for change but feel stuck, anxious, or unsure where to start, you’re not alone. I specialize in helping individuals through major life transitions, navigating relationship issues, and managing anxiety and depression. My relational approach focuses on building a trusting, non-judgmental therapeutic relationship that is essential for healing and meaningful change.
Do you feel lost or overwhelmed about the direction of your life, relationships, or the state of the world? Is uncertainty or hopelessness making it hard to stay present and engaged? Is your connection with yourself and others suffering because of it? If you sense a need for change but feel stuck, anxious, or unsure where to start, you’re not alone. I specialize in helping individuals through major life transitions, navigating relationship issues, and managing anxiety and depression. My relational approach focuses on building a trusting, non-judgmental therapeutic relationship that is essential for healing and meaningful change.
Navigating the path to therapy or seeking a new therapist can feel like an overwhelming journey. My therapeutic approach begins with establishing a strong connection with my clients - fostering an environment where the healing process can organically unfold. My ultimate objective is to empower clients through self-motivation and self-awareness that leads to transformative changes and an enhanced quality of life. I enjoy working with adolescents and adults - my expertise includes a wide range of clinical issues such as anxiety, depression, relationship challenges and life transitions.
Navigating the path to therapy or seeking a new therapist can feel like an overwhelming journey. My therapeutic approach begins with establishing a strong connection with my clients - fostering an environment where the healing process can organically unfold. My ultimate objective is to empower clients through self-motivation and self-awareness that leads to transformative changes and an enhanced quality of life. I enjoy working with adolescents and adults - my expertise includes a wide range of clinical issues such as anxiety, depression, relationship challenges and life transitions.
Rachel Brookland
Psychologist, PsyD
Verified Verified
2 Endorsed
Philadelphia, PA 19123 (Online Only)
Waitlist for new clients
Women experience very unique challenges, which influence overall well-being, contentedness, and connection. Together we will build awareness and understanding of your experiences. We will identify how thoughts, feeling, and behaviors influence each other and gain tools to foster growth and wellness. My therapeutic work includes working with individuals coping with women's health issues, including, perinatal and postpartum depression/anxiety. infertility, adjustment disorders, anxiety, work-life balance, stress management, and relationship/communication issues.
Women experience very unique challenges, which influence overall well-being, contentedness, and connection. Together we will build awareness and understanding of your experiences. We will identify how thoughts, feeling, and behaviors influence each other and gain tools to foster growth and wellness. My therapeutic work includes working with individuals coping with women's health issues, including, perinatal and postpartum depression/anxiety. infertility, adjustment disorders, anxiety, work-life balance, stress management, and relationship/communication issues.
Nikki Walter
Pre-Licensed Professional, MFT
Verified Verified
5 Endorsed
Philadelphia, PA 19123 (Online Only)
I specialize in treating depression, anxiety, trauma, and PTSD using a relational lens. My therapist vibe is "professional friend" and while we will explore heavy, painful topics, therapy is not going to be a huge bummer the whole time. We will joke, we will riff, we will come up for air. No matter what you're going through, or have faced in the past, I sincerely believe that healing is possible and would be honored to support you on that journey.
I specialize in treating depression, anxiety, trauma, and PTSD using a relational lens. My therapist vibe is "professional friend" and while we will explore heavy, painful topics, therapy is not going to be a huge bummer the whole time. We will joke, we will riff, we will come up for air. No matter what you're going through, or have faced in the past, I sincerely believe that healing is possible and would be honored to support you on that journey.
In life, you will find yourself needing different types of support depending on the circumstances you are doing your best to manage. This can look like grieving a loss, reflecting on your family dynamic, wanting better skills to connect with others, or healing from painful experiences. I will support you in exploring what brings meaning to your life while building insight into your emotions and behavior. The space that we create together will provide you with the safety and connection you need to grow as an individual and within your relationships.
In life, you will find yourself needing different types of support depending on the circumstances you are doing your best to manage. This can look like grieving a loss, reflecting on your family dynamic, wanting better skills to connect with others, or healing from painful experiences. I will support you in exploring what brings meaning to your life while building insight into your emotions and behavior. The space that we create together will provide you with the safety and connection you need to grow as an individual and within your relationships.
15 Second Videos
Loran Grishow-Schade
Ayla Fleming
Shayan Salar
Full Being Services
Rachel Brookland
Nikki Walter
Megan Bousquet
James Wadley
Jennifer V Kulka
'aloe' Sarah Michelson
Maia Rosser
Kirk Burke Hamilton
River Wards Wellness Collective
Jennifer V Kulka
Kelly Jude, LCSW
Felix A Perez
Lauren Callahan
Faith Iloka
Kara Lacey
Diana Snyder
Jill Garcia Toale
Perez Therapy, LLC
Annette Deigh, Boundary Span, LLC
Alfreda Davis
Brittany Morrow - Women's Issues - Postpartum - Life Transition Specialist
Elizabeth Merrell
Melrose Patton
Daniel Mack Specializing In Men And People Of Color
Jessica Renee Blanding-Coleman
Licensed Professional Counselor, MS, LPC
Verified Verified
Philadelphia, PA 19123 (Online Only)
If only life were as easy as scrolling through counselor profiles. Let me help you bring healing and understanding to life's difficulties so you can move past them and into a better mind space. I am experienced in all areas of mental health, but I am highly effective in treating stress, anxiety, and depression. In addition to working with those experiencing difficult life transitions such as loss and divorce, I also enjoy working with women's issues such as infertility, postpartum conditions, parenting issues, and adjustments dealing with weight loss.
If only life were as easy as scrolling through counselor profiles. Let me help you bring healing and understanding to life's difficulties so you can move past them and into a better mind space. I am experienced in all areas of mental health, but I am highly effective in treating stress, anxiety, and depression. In addition to working with those experiencing difficult life transitions such as loss and divorce, I also enjoy working with women's issues such as infertility, postpartum conditions, parenting issues, and adjustments dealing with weight loss.
Megan Bousquet
Licensed Professional Counselor, MA, ATR, LPC
Verified Verified
4 Endorsed
Philadelphia, PA 19123 (Online Only)
Throughout a woman’s life there are many emotional shifts and it takes strength to reach out for support! I understand the many challenges and stress that sometimes might have you not feeling like yourself. Do you feel alone, anxious, tired, sad, angry, irritable, or stressed? I work with women who are experiencing anxiety, depressed mood, grief and loss, fertility, miscarriage, transition to motherhood, and other life changing events. I have specialized training in anxiety, maternal mental health (pregnancy, birth, postpartum, motherhood), child development, and eating disorders.
Throughout a woman’s life there are many emotional shifts and it takes strength to reach out for support! I understand the many challenges and stress that sometimes might have you not feeling like yourself. Do you feel alone, anxious, tired, sad, angry, irritable, or stressed? I work with women who are experiencing anxiety, depressed mood, grief and loss, fertility, miscarriage, transition to motherhood, and other life changing events. I have specialized training in anxiety, maternal mental health (pregnancy, birth, postpartum, motherhood), child development, and eating disorders.
I offer a creative and collaborative therapeutic alliance to co-create a safe and non-judgmental space for you to explore your understanding of yourself and the world around you. Life can often feel like it is happening at us, leaving us feeling powerless, anxious, depressed, and stuck. I believe we all have the power to tell our own stories and create our own paths. I believe whole heartedly that is my privilege to support you to reach an improved quality of life and a deeper level of self-awareness, acceptance and efficacy.
I offer a creative and collaborative therapeutic alliance to co-create a safe and non-judgmental space for you to explore your understanding of yourself and the world around you. Life can often feel like it is happening at us, leaving us feeling powerless, anxious, depressed, and stuck. I believe we all have the power to tell our own stories and create our own paths. I believe whole heartedly that is my privilege to support you to reach an improved quality of life and a deeper level of self-awareness, acceptance and efficacy.
James Wadley
Licensed Professional Counselor, PhD, LPC, NCC, CSTS, IMHF
Verified Verified
3 Endorsed
Philadelphia, PA 19123
Do you have trust issues in your relationship? Are you afraid to be honest with your partner or tired of trying to be someone you're not? Neither you or your partner are really talking about your hurt or resentments over pornography and infidelity. You've tried over and over again and the current situation isn't working for you and/or your relationship. Contact me and we will talk about how you feel about your challenges and together come up with a behavioral and emotional strategy for you to move forward! By the end of our FIRST session, you will be given therapeutic goals that you and I will work on.
Do you have trust issues in your relationship? Are you afraid to be honest with your partner or tired of trying to be someone you're not? Neither you or your partner are really talking about your hurt or resentments over pornography and infidelity. You've tried over and over again and the current situation isn't working for you and/or your relationship. Contact me and we will talk about how you feel about your challenges and together come up with a behavioral and emotional strategy for you to move forward! By the end of our FIRST session, you will be given therapeutic goals that you and I will work on.
Mai Spann-Wilson
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Philadelphia, PA 19123
Hello, and thanks for visiting my profile. My name is Mai, and I offer sessions both in-person and through Telehealth. I understand that you might be experiencing a difficult time, whether it's a significant transition, a loss, or feelings you’re unsure how to handle. This can be overwhelming and scary, and sometimes the hardest step is acknowledging the need for help. I believe in the innate capacity we all have to heal and grow, and I am here to help you uncover this strength within yourself. Since 2013, I have worked extensively with individuals, couples, and families, helping them navigate various life challenges.
Hello, and thanks for visiting my profile. My name is Mai, and I offer sessions both in-person and through Telehealth. I understand that you might be experiencing a difficult time, whether it's a significant transition, a loss, or feelings you’re unsure how to handle. This can be overwhelming and scary, and sometimes the hardest step is acknowledging the need for help. I believe in the innate capacity we all have to heal and grow, and I am here to help you uncover this strength within yourself. Since 2013, I have worked extensively with individuals, couples, and families, helping them navigate various life challenges.
Susanna Baldwin Vargo
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Philadelphia, PA 19123 (Online Only)
Is this your first time seeking therapy? We may be a great fit! In therapy, we explore things that get in the way of your ability to connect to yourself or your relationships with others. We address the fullness of the human experience that can range from fears, losses, and heartbreak to success, well-being, and self-empowerment. We identify your personal strengths and develop tools together that enable you to better manage present and future changes and challenges as they arise. I also have experience working with healthcare providers.
Is this your first time seeking therapy? We may be a great fit! In therapy, we explore things that get in the way of your ability to connect to yourself or your relationships with others. We address the fullness of the human experience that can range from fears, losses, and heartbreak to success, well-being, and self-empowerment. We identify your personal strengths and develop tools together that enable you to better manage present and future changes and challenges as they arise. I also have experience working with healthcare providers.
Monica Santiago
Clinical Social Work/Therapist, MSW
Verified Verified
3 Endorsed
Philadelphia, PA 19123 (Online Only)
Seeking help and support is a sign of personal strength, not an admission of weakness. However, this is not the message we always receive from those around us. Engaging in therapy can be a scary thing to sign up for. I take this into account when meeting with my clients. I believe in providing my clients with a sincere effort to build a therapeutic relationship by getting to know each person and providing professional, honest feedback to move forward towards their personal growth. I believe in addressing personal goals and checking in on where the client’s mindset is, as life tends to throw us unexpected changes at unexpected times.
Seeking help and support is a sign of personal strength, not an admission of weakness. However, this is not the message we always receive from those around us. Engaging in therapy can be a scary thing to sign up for. I take this into account when meeting with my clients. I believe in providing my clients with a sincere effort to build a therapeutic relationship by getting to know each person and providing professional, honest feedback to move forward towards their personal growth. I believe in addressing personal goals and checking in on where the client’s mindset is, as life tends to throw us unexpected changes at unexpected times.
When it comes to our lives and sense of self, our inner wisdom can become drowned out by the noise of circumstance and context. I believe that therapy is a journey that allows us to hear that wisdom again (or for the first time) and ultimately, (re) connect to ourselves. It is a space where we can explore the different parts of ourselves, where we befriend and harmonize with our inner characters, bringing our inner world into better alignment so that we can find peace in our external world. Therapy also involves exploring ways in which we can build a soul-nourishing community, both internally and externally, for ourselves.
When it comes to our lives and sense of self, our inner wisdom can become drowned out by the noise of circumstance and context. I believe that therapy is a journey that allows us to hear that wisdom again (or for the first time) and ultimately, (re) connect to ourselves. It is a space where we can explore the different parts of ourselves, where we befriend and harmonize with our inner characters, bringing our inner world into better alignment so that we can find peace in our external world. Therapy also involves exploring ways in which we can build a soul-nourishing community, both internally and externally, for ourselves.
Johanna Dwinells
Licensed Professional Counselor, LPC, MA, MT-BC
Verified Verified
Philadelphia, PA 19123 (Online Only)
Hello and welcome! I am a licensed professional counselor based in Philadelphia. I specialized in helping clients with anxiety, but that's not all! I've helped clients with creative slumps, significant life changes and day to day issues. Let's work together to lighten your mental load and uncover self acceptance. From the smallest struggles to the large problems that life throws at us, I can be in your corner.
Hello and welcome! I am a licensed professional counselor based in Philadelphia. I specialized in helping clients with anxiety, but that's not all! I've helped clients with creative slumps, significant life changes and day to day issues. Let's work together to lighten your mental load and uncover self acceptance. From the smallest struggles to the large problems that life throws at us, I can be in your corner.
See more therapy options for 19123
How does your Therapist compare?
Number of Therapists in 19123
100+
Average cost per session
$150
Therapists in 19123 who prioritize treating:
96% | Anxiety |
91% | Depression |
69% | Coping Skills |
69% | Self Esteem |
68% | Relationship Issues |
66% | Trauma and PTSD |
65% | Stress |
Average years in practice
10 Years
Top 3 insurances accepted
94% | Aetna |
87% | Cigna and Evernorth |
83% | Optum |
How Therapists in 19123 see their clients
65% | Online Only | |
35% | In Person and Online |
Gender breakdown
80% | Female | |
18% | Male | |
2% | Non-Binary |
FAQs - About Therapy and Counseling
How can I find a therapist in 19123?
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
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.
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.
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.