Photo of Michael Glen Keith, LCSW, Clinical Social Work/Therapist
Michael Glen Keith
Clinical Social Work/Therapist, LCSW
Verified Verified
Falls Church, VA 22043  (Online Only)
I use both short term and longer term psychotherapy in order to provide more choice for my clients. My clients are adults of any age. I work primarily with depression and anxiety, especially people going through stressful transitions. I focus on good relationships within groups and within individuals. When someone comes to see me they can expect that I will listen to what they want to work on and then work together to find solutions.
I use both short term and longer term psychotherapy in order to provide more choice for my clients. My clients are adults of any age. I work primarily with depression and anxiety, especially people going through stressful transitions. I focus on good relationships within groups and within individuals. When someone comes to see me they can expect that I will listen to what they want to work on and then work together to find solutions.
(571) 556-8149 View (571) 556-8149
Photo of Kathleen Cotter Cauley, MEd, LMFT, Marriage & Family Therapist
Kathleen Cotter Cauley
Marriage & Family Therapist, MEd, LMFT
Verified Verified
Falls Church, VA 22043  (Online Only)
Not accepting new clients
I have a general practice with individuals, couples,and families. People come with the hope of improving their relationships at home and at work. The effort is on managing their own stress levels, learning about self regulation and reactivity in all of their relationships (examination of daily habits, spiritual life, technology management, etc) People often are requesting assistance in managing life's challenges( illness, death, parenting, premarital, marriage, and stepfamily information). They are interested in becoming the best "self" that they are capable of becoming in relationship to others. The relationships surrounding the client are part of the discussion.
I have a general practice with individuals, couples,and families. People come with the hope of improving their relationships at home and at work. The effort is on managing their own stress levels, learning about self regulation and reactivity in all of their relationships (examination of daily habits, spiritual life, technology management, etc) People often are requesting assistance in managing life's challenges( illness, death, parenting, premarital, marriage, and stepfamily information). They are interested in becoming the best "self" that they are capable of becoming in relationship to others. The relationships surrounding the client are part of the discussion.
(703) 831-6551 View (703) 831-6551
Photo of Mehrnush Mohebi - Center for Clinical Health Solutions, EdD, LMHP, LPC, Licensed Professional Counselor
Center for Clinical Health Solutions
Licensed Professional Counselor, EdD, LMHP, LPC
Verified Verified
Falls Church, VA 22043
We are experienced mental health and behavioral health professionals working closely with the families, individuals and couples in processing the undesirable situations and maladaptive behaviors, identifying the dysfunctional coping strategies and substituting it with appropriate skills in a therapeutic setting. We work together to advocate for self and thrive. We open a new horizon for individuals diagnosed under autism spectrum, learning disabilities and Serious Mental Illnesses to fulfill and achieve life long goals. We provide support as it fits your life style and preferences to have successful stand in life.
We are experienced mental health and behavioral health professionals working closely with the families, individuals and couples in processing the undesirable situations and maladaptive behaviors, identifying the dysfunctional coping strategies and substituting it with appropriate skills in a therapeutic setting. We work together to advocate for self and thrive. We open a new horizon for individuals diagnosed under autism spectrum, learning disabilities and Serious Mental Illnesses to fulfill and achieve life long goals. We provide support as it fits your life style and preferences to have successful stand in life.
(571) 620-6019 View (571) 620-6019
Photo of Ashley Curl, LCSW, CGP, Clinical Social Work/Therapist
Ashley Curl
Clinical Social Work/Therapist, LCSW, CGP
Verified Verified
Falls Church, VA 22043
How the hell did I/we end up here? When are things going to finally shift for me/us? Life, relationships, job: Could be worse, but could be waaaay better. If any of these statements capture where you're at - welcome to therapy. Whether it's your first time looking for a therapist, or your second decade in treatment, with me, you can bring your whole self - with its questions, stuckness, fears, longings, uncertainties - and find ways to move through. Described as "warm" and "direct" by clients, my work is strongly grounded by anti-racism, critical multicultural theories, and affective neuroscience.
How the hell did I/we end up here? When are things going to finally shift for me/us? Life, relationships, job: Could be worse, but could be waaaay better. If any of these statements capture where you're at - welcome to therapy. Whether it's your first time looking for a therapist, or your second decade in treatment, with me, you can bring your whole self - with its questions, stuckness, fears, longings, uncertainties - and find ways to move through. Described as "warm" and "direct" by clients, my work is strongly grounded by anti-racism, critical multicultural theories, and affective neuroscience.
(571) 520-6865 View (571) 520-6865
Photo of Marc D Grande, PsyD, Psychologist
Marc D Grande
Psychologist, PsyD
Verified Verified
1 Endorsed
Falls Church, VA 22043
I specialize in child and adolescent psychology and also see adults. For children and adolescents, I utilize sand-tray and play therapy methods as well as individual therapy. In addition, I offer comprehensive testing and diagnostic services for emotional and behavioral issues, intelligence testing, and psychoeducational assessment. For adults, I focus on depression/anxiety, personality issues and life-transitions.
I specialize in child and adolescent psychology and also see adults. For children and adolescents, I utilize sand-tray and play therapy methods as well as individual therapy. In addition, I offer comprehensive testing and diagnostic services for emotional and behavioral issues, intelligence testing, and psychoeducational assessment. For adults, I focus on depression/anxiety, personality issues and life-transitions.
(703) 957-7867 View (703) 957-7867
Photo of Eric Niler, PhD, Psychologist
Eric Niler
Psychologist, PhD
Verified Verified
Falls Church, VA 22043  (Online Only)
I have been a psychologist for 30+ years, and in the past year I've transitioned to a telehealth only model, so that you can receive treatment from the comfort of your home. Using cognitive-behavioral therapy (CBT), I treat adults with anxiety, depression, chronic pain, trauma/abuse, adjustment disorders, and work-related stresses.
I have been a psychologist for 30+ years, and in the past year I've transitioned to a telehealth only model, so that you can receive treatment from the comfort of your home. Using cognitive-behavioral therapy (CBT), I treat adults with anxiety, depression, chronic pain, trauma/abuse, adjustment disorders, and work-related stresses.
(571) 701-1693 View (571) 701-1693
Photo of Mandana Roushan, BCBA
Mandana Roushan
BCBA
Verified Verified
Falls Church, VA 22043
I am a Behaviorist with over 5 years of experience using Applied Behavior Analysis to treat individuals with mental and behavioral challenges . As a Nurse, Master in Educational psychology in Human Relations and Licensed Behavior Analyst , I have a unique skill set tailored toward helping people of many different functioning levels reach their fullest potential at home, school/work, and most importantly in their present moment . I have been working with children, adolescents, and adults for over 8 years in the areas of Behavioral/Emotional Disorders, Anxiety/Mood Disorders and Developmental Disabilities.
I am a Behaviorist with over 5 years of experience using Applied Behavior Analysis to treat individuals with mental and behavioral challenges . As a Nurse, Master in Educational psychology in Human Relations and Licensed Behavior Analyst , I have a unique skill set tailored toward helping people of many different functioning levels reach their fullest potential at home, school/work, and most importantly in their present moment . I have been working with children, adolescents, and adults for over 8 years in the areas of Behavioral/Emotional Disorders, Anxiety/Mood Disorders and Developmental Disabilities.
(520) 253-7608 View (520) 253-7608
Photo of Dorothy Ann Wine, LCSW, Clinical Social Work/Therapist
Dorothy Ann Wine
Clinical Social Work/Therapist, LCSW
Verified Verified
Falls Church, VA 22043
I'm here to listen and to care, there is hope and help. I don't want you to feel this way one more day. Where there is lack of understanding, let's find meaning.I stand ready to support you on your jouney to flourish! I've successfully helped couples rediscover their loving relationship. Yes. It’s possible. Let’s work to build satisfying relationships. To understand and dentifythe triggers that lead to anxiety and depression. While planning supports your strengths. It would be a privilege to assist you on this journey. Together we can plan strategies to move forward to positive change.
I'm here to listen and to care, there is hope and help. I don't want you to feel this way one more day. Where there is lack of understanding, let's find meaning.I stand ready to support you on your jouney to flourish! I've successfully helped couples rediscover their loving relationship. Yes. It’s possible. Let’s work to build satisfying relationships. To understand and dentifythe triggers that lead to anxiety and depression. While planning supports your strengths. It would be a privilege to assist you on this journey. Together we can plan strategies to move forward to positive change.
(571) 248-3358 View (571) 248-3358
Photo of Milov Sonnier, LCSW, Clinical Social Work/Therapist
Milov Sonnier
Clinical Social Work/Therapist, LCSW
Verified Verified
Falls Church, VA 22043
I am Milov Sonnier a Licensed Clinical Social Worker based in Virginia. I work with clients statewide via telehealth. I specialize in women's issues, trauma, PTSD, thought disorders, stress, anxiety, depression, relationship issues and more. I use integrative approaches to help my clients make progress and to begin to feel better. I have found that my style and approach is a good fit for adults who are experiencing transition periods in their lives, and have traumatic memories that surface due to a current life stressor's.
I am Milov Sonnier a Licensed Clinical Social Worker based in Virginia. I work with clients statewide via telehealth. I specialize in women's issues, trauma, PTSD, thought disorders, stress, anxiety, depression, relationship issues and more. I use integrative approaches to help my clients make progress and to begin to feel better. I have found that my style and approach is a good fit for adults who are experiencing transition periods in their lives, and have traumatic memories that surface due to a current life stressor's.
(804) 596-4915 View (804) 596-4915
Photo of Erin Capozzi, LCSW, LCSW-C, Clinical Social Work/Therapist
Erin Capozzi
Clinical Social Work/Therapist, LCSW, LCSW-C
Verified Verified
Falls Church, VA 22043  (Online Only)
Being a parent, family member or worker is an everyday challenge. Most of the time, we manage just fine. There are times, though, when life doesn't feel so manageable and we end up stressed and anxious, sluggish or unmotivated or we turn to substances or other diversions to cope. I can help. I work with people in a very practical, down-to-earth way that is goal-oriented and solution focused.
Being a parent, family member or worker is an everyday challenge. Most of the time, we manage just fine. There are times, though, when life doesn't feel so manageable and we end up stressed and anxious, sluggish or unmotivated or we turn to substances or other diversions to cope. I can help. I work with people in a very practical, down-to-earth way that is goal-oriented and solution focused.
(703) 991-6544 View (703) 991-6544
Photo of Neil K Makstein, PhD, Psychologist
Neil K Makstein
Psychologist, PhD
Verified Verified
1 Endorsed
Falls Church, VA 22043
I see adults and adolescents of any age . I see quite a few couples and families to work through marital or parenting problems. Most of my clients are seeking insight about how to approach their problems in new ways, to acquire new understandings which enable them to see possibilities that may have been elusive to them without the added input of an experienced therapist. I have tried to develop a style that focuses on how to help people develop their capacity to tune in more deeply to their own inner awareness and knowledge, to see options that were previously unseen.
I see adults and adolescents of any age . I see quite a few couples and families to work through marital or parenting problems. Most of my clients are seeking insight about how to approach their problems in new ways, to acquire new understandings which enable them to see possibilities that may have been elusive to them without the added input of an experienced therapist. I have tried to develop a style that focuses on how to help people develop their capacity to tune in more deeply to their own inner awareness and knowledge, to see options that were previously unseen.
(703) 957-7741 View (703) 957-7741
Photo of Dionne Dauphin Green, LPC, Licensed Professional Counselor
Dionne Dauphin Green
Licensed Professional Counselor, LPC
Verified Verified
Falls Church, VA 22043
Hi, my name is Dr. Dionne Dauphin Green. I am a Licensed Professional Counselor with over 11 years of experience. I focus on the family, including adults and children, using cognitive behavioral and trauma-focused therapy to help my clients to obtain a clearer perspective on life. I have experience in working with adults and children with a history of inpatient mental health treatment, substance abuse, and crisis management. I have also worked alongside families and children in the juvenile justice system.
Hi, my name is Dr. Dionne Dauphin Green. I am a Licensed Professional Counselor with over 11 years of experience. I focus on the family, including adults and children, using cognitive behavioral and trauma-focused therapy to help my clients to obtain a clearer perspective on life. I have experience in working with adults and children with a history of inpatient mental health treatment, substance abuse, and crisis management. I have also worked alongside families and children in the juvenile justice system.
(571) 548-3845 View (571) 548-3845
Photo of Joanna Spiro, PsyD, Psychologist
Joanna Spiro
Psychologist, PsyD
Verified Verified
Falls Church, VA 22043  (Online Only)
I work collaboratively, creating an atmosphere of safety and honesty in which to address difficult issues and to pursue understanding and growth. I have worked with people dealing with a wide range of problems, including depression, anxiety, relationship and family issues, life transitions, identity issues, and the effects of traumatic experiences.
I work collaboratively, creating an atmosphere of safety and honesty in which to address difficult issues and to pursue understanding and growth. I have worked with people dealing with a wide range of problems, including depression, anxiety, relationship and family issues, life transitions, identity issues, and the effects of traumatic experiences.
(571) 450-9125 View (571) 450-9125
Photo of Jihan Farmand, MSW, LICSW, Clinical Social Work/Therapist
Jihan Farmand
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
1 Endorsed
Falls Church, VA 22043  (Online Only)
As a psychotherapist with 15 plus years of experience, my goal is always to individually tailor a therapeutic approach and plan that best meets each client’s specific needs, as there’s no one size fits all. My approach will always begin where the client is, collaboratively build agreed upon goals, and work together to empower each client to meet those goals at his or her own pace. I've been described as warm, funny, but direct.
As a psychotherapist with 15 plus years of experience, my goal is always to individually tailor a therapeutic approach and plan that best meets each client’s specific needs, as there’s no one size fits all. My approach will always begin where the client is, collaboratively build agreed upon goals, and work together to empower each client to meet those goals at his or her own pace. I've been described as warm, funny, but direct.
(571) 506-3082 View (571) 506-3082
Photo of Jessica Stoler, LPC, CCTP-II, Licensed Professional Counselor
Jessica Stoler
Licensed Professional Counselor, LPC, CCTP-II
Verified Verified
2 Endorsed
Falls Church, VA 22043  (Online Only)
The most courageous thing we can do is to learn, rather unlearn, behaviors and patterns that are no longer serving us. My expertise is in helping adults and children unlearn patterns from Trauma, Anxiety, and Substance Abuse in order to drastically improve your quality of life. I am experienced in working with marginalized populations as well as the general public.
The most courageous thing we can do is to learn, rather unlearn, behaviors and patterns that are no longer serving us. My expertise is in helping adults and children unlearn patterns from Trauma, Anxiety, and Substance Abuse in order to drastically improve your quality of life. I am experienced in working with marginalized populations as well as the general public.
(571) 450-9135 View (571) 450-9135
Photo of Shane A Lanzo, LCSW, LICSW, Clinical Social Work/Therapist
Shane A Lanzo
Clinical Social Work/Therapist, LCSW, LICSW
Verified Verified
Falls Church, VA 22043  (Online Only)
I strive to be present, attentive, emotionally attuned, to bear witness to one’s narrative and experiences, and to provide individual clients with a safe space to unearth, process, and make sense of things in their life that have stymied or thwarted them, resulting in undesirable patterns of thought, behaviors, and or symptoms. I am a Licensed Clinical Social Worker (LCSW - VA) (LICSW – D.C.) with 22 years of experience working with adolescents, young adults, adults, and older adults in both inpatient and outpatient medical and community settings.
I strive to be present, attentive, emotionally attuned, to bear witness to one’s narrative and experiences, and to provide individual clients with a safe space to unearth, process, and make sense of things in their life that have stymied or thwarted them, resulting in undesirable patterns of thought, behaviors, and or symptoms. I am a Licensed Clinical Social Worker (LCSW - VA) (LICSW – D.C.) with 22 years of experience working with adolescents, young adults, adults, and older adults in both inpatient and outpatient medical and community settings.
(571) 701-2324 View (571) 701-2324
Photo of Rita Etter, MSW, LCSW, LCSW-C, Clinical Social Work/Therapist
Rita Etter
Clinical Social Work/Therapist, MSW, LCSW, LCSW-C
Verified Verified
2 Endorsed
Falls Church, VA 22043  (Online Only)
I am an LCSW-C therapist who works with adults and couples. Life has a way of presenting people with challenges that may cause you to want to seek counseling to help you navigate your way through life's ups and downs. Sometimes these challenges make us feel stuck and uncertain, whether it be relationship issues, divorce, intimacy, death of a loved one, loss of a job, grief, suicide survivor, identity crisis, family conflict, addiction, processing trauma, sexual orientation, communicating or relating better, building coping skills and resilience, etc., or simply feeling like you are at a crossroads and not sure what to do next.
I am an LCSW-C therapist who works with adults and couples. Life has a way of presenting people with challenges that may cause you to want to seek counseling to help you navigate your way through life's ups and downs. Sometimes these challenges make us feel stuck and uncertain, whether it be relationship issues, divorce, intimacy, death of a loved one, loss of a job, grief, suicide survivor, identity crisis, family conflict, addiction, processing trauma, sexual orientation, communicating or relating better, building coping skills and resilience, etc., or simply feeling like you are at a crossroads and not sure what to do next.
(703) 951-7002 View (703) 951-7002
Photo of Dr. Cathy Lau-Barraco, PhD, Psychologist
Dr. Cathy Lau-Barraco
Psychologist, PhD
Verified Verified
Falls Church, VA 22043  (Online Only)
Are you feeling overwhelmed, lost, or disconnected from those around you? Do you often feel weighed down, unable to shake a sense of heaviness despite your best efforts? Therapy could be the support you need. Hi, I'm Dr. Cathy, and I help guide young adults like you towards a more meaningful and fulfilling life. Together, we'll uncover the underlying issues holding you back and develop a clear, personalized path to help you achieve your goals.
Are you feeling overwhelmed, lost, or disconnected from those around you? Do you often feel weighed down, unable to shake a sense of heaviness despite your best efforts? Therapy could be the support you need. Hi, I'm Dr. Cathy, and I help guide young adults like you towards a more meaningful and fulfilling life. Together, we'll uncover the underlying issues holding you back and develop a clear, personalized path to help you achieve your goals.
(678) 928-8275 View (678) 928-8275
Photo of Jeffrey S Selman, PsyD, BCBA-D, Psychologist
Jeffrey S Selman
Psychologist, PsyD, BCBA-D
Verified Verified
Falls Church, VA 22043
My name is Dr. Jeff Selman and I am a licensed psychologist, Board Certified Behavior Analyst (BCBA), and a certified school psychologist. I offer evidence-based telepsychology services to individuals across the lifespan and their families. These services include autism screening and assessment, individual and family therapy, parent behavior management training and coaching, and consultation and training for schools and community agencies. My approach is grounded in cognitive behavior therapy and behavior therapy. My sessions tend to be active, goal-oriented, and engaging. I love the work and welcomes complex and challenging cases.
My name is Dr. Jeff Selman and I am a licensed psychologist, Board Certified Behavior Analyst (BCBA), and a certified school psychologist. I offer evidence-based telepsychology services to individuals across the lifespan and their families. These services include autism screening and assessment, individual and family therapy, parent behavior management training and coaching, and consultation and training for schools and community agencies. My approach is grounded in cognitive behavior therapy and behavior therapy. My sessions tend to be active, goal-oriented, and engaging. I love the work and welcomes complex and challenging cases.
(843) 351-1460 View (843) 351-1460
Photo of Terri Higgins, LPC, Licensed Professional Counselor
Terri Higgins
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
Falls Church, VA 22043
Not accepting new clients
My approach to therapy uses Internal Family Systems, an insight-oriented therapy which is a powerful method for understanding conflict, trauma, and defenses, and for promoting healing, change, self-empowerment and self-compassion. I view the counseling process as a partnership and an opportunity for you to learn more about yourself. We will honor the patterns that have kept you safe in the past, while at the same time gently removing the barriers that have kept you from being the person you wish to be. I utilize EMDR in my work as well to address trauma that happened long ago, as well as any recent trauma.
My approach to therapy uses Internal Family Systems, an insight-oriented therapy which is a powerful method for understanding conflict, trauma, and defenses, and for promoting healing, change, self-empowerment and self-compassion. I view the counseling process as a partnership and an opportunity for you to learn more about yourself. We will honor the patterns that have kept you safe in the past, while at the same time gently removing the barriers that have kept you from being the person you wish to be. I utilize EMDR in my work as well to address trauma that happened long ago, as well as any recent trauma.
(434) 337-3797 View (434) 337-3797
1

How does your Therapist compare?

Number of Therapists in 22043

80+

Average cost per session

$175

Therapists in 22043 who prioritize treating:

93% Anxiety
85% Depression
68% Relationship Issues
67% Grief
67% Self Esteem
62% Trauma and PTSD
54% Stress

Average years in practice

18 Years

Top 3 insurances accepted

78% BlueCross and BlueShield
68% Cigna and Evernorth
65% Aetna

How Therapists in 22043 see their clients

71% In Person and Online
29% Online Only

Gender breakdown

80% Female
20% Male
FAQs - About Therapy and Counseling

How can I find a therapist in 22043?

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.