Photo of Kenneth Kronheim, LPC, Licensed Professional Counselor
Kenneth Kronheim
Licensed Professional Counselor, LPC
Verified Verified
Machipongo, VA 23405
Ken Kronheim has been a licensed therapist since 2007. As a retired fire rescue chief, Ken possesses the experience and insight not only to ease physical suffering but help mental health as well. Ken's goal is to not only make you "feel" better but also help you "get" better. My focus Ken has a vast amount of experience with front-line/professional personnel such as first responders, medical field, military, law, educators and their families as well as college aged students. Ken utilizes an eclectic approach to therapy while primarily utilizing CBT, REBT, and solution-focused techniques.
Ken Kronheim has been a licensed therapist since 2007. As a retired fire rescue chief, Ken possesses the experience and insight not only to ease physical suffering but help mental health as well. Ken's goal is to not only make you "feel" better but also help you "get" better. My focus Ken has a vast amount of experience with front-line/professional personnel such as first responders, medical field, military, law, educators and their families as well as college aged students. Ken utilizes an eclectic approach to therapy while primarily utilizing CBT, REBT, and solution-focused techniques.
(434) 722-3871 View (434) 722-3871
Photo of Christina Ford-Shannon, LCSW, Clinical Social Work/Therapist
Christina Ford-Shannon
Clinical Social Work/Therapist, LCSW
Verified Verified
Machipongo, VA 23405
I am a Licensed Clinical Social Worker based in Virginia with 16 years of experience working with people navigating a variety of life circumstances. I enjoy 1:1 therapy using various therapeutic techniques such as cognitive-behavioral therapy, narrative therapy, and interpersonal therapy techniques to equip clients with better problem-solving, stress management, and coping skills. I have a passion for working with teenage clients experiencing depression, anxiety, and anger management issues.
I am a Licensed Clinical Social Worker based in Virginia with 16 years of experience working with people navigating a variety of life circumstances. I enjoy 1:1 therapy using various therapeutic techniques such as cognitive-behavioral therapy, narrative therapy, and interpersonal therapy techniques to equip clients with better problem-solving, stress management, and coping skills. I have a passion for working with teenage clients experiencing depression, anxiety, and anger management issues.
(571) 556-8165 View (571) 556-8165

More Therapists Nearby

Photo of Karen Johnston, Pre-Licensed Professional
Karen Johnston
Pre-Licensed Professional
Verified Verified
Keller, VA 23401
I am Karen Johnston, a Resident in Counseling (RIC) working towards full licensure as an LPC with over 6 years of experience. I am passionate about helping people and couples of all ages and backgrounds address challenges and trauma they may have faced in the past or are currently facing. I specialize in anxiety, grief, trauma, depression, behavioral problems, and relationship issues.
I am Karen Johnston, a Resident in Counseling (RIC) working towards full licensure as an LPC with over 6 years of experience. I am passionate about helping people and couples of all ages and backgrounds address challenges and trauma they may have faced in the past or are currently facing. I specialize in anxiety, grief, trauma, depression, behavioral problems, and relationship issues.
(757) 780-1512 View (757) 780-1512
Photo of Melissa Marks, LPC, Licensed Professional Counselor
Melissa Marks
Licensed Professional Counselor, LPC
Verified Verified
Painter, VA 23420
I have an array of hands-on experience from initially beginning in healthcare and later transitioning into mental health. I received a master's degree in Marriage and Family in 2013 and a master's degree in Professional Counseling in 2015. I have worked with children, adolescents, and adults struggling with anxiety, depression, PTSD, anger, mood instability, and substance abuse. I believe that we all experience moments where we need additional support and someone to walk alongside us on our journey.
I have an array of hands-on experience from initially beginning in healthcare and later transitioning into mental health. I received a master's degree in Marriage and Family in 2013 and a master's degree in Professional Counseling in 2015. I have worked with children, adolescents, and adults struggling with anxiety, depression, PTSD, anger, mood instability, and substance abuse. I believe that we all experience moments where we need additional support and someone to walk alongside us on our journey.
(757) 797-9105 View (757) 797-9105
Photo of Keshawna Tiggle, LPC, Licensed Professional Counselor
Keshawna Tiggle
Licensed Professional Counselor, LPC
Verified Verified
Birdsnest, VA 23307
My name is Keshawna Tiggle and I'm a Licensed Professional Counseling (LPC) in Virginia. My approach to therapy is very much person-centered. Clients are in control of their lives and treatment and I'm here to support through the use of various empathetic interventions. I have years of experience working with individuals, who struggle with various mood disorders, anxiety, depression, suicidal ideation, self-harm, depression, life changes, school challenges, self-esteem, etc.
My name is Keshawna Tiggle and I'm a Licensed Professional Counseling (LPC) in Virginia. My approach to therapy is very much person-centered. Clients are in control of their lives and treatment and I'm here to support through the use of various empathetic interventions. I have years of experience working with individuals, who struggle with various mood disorders, anxiety, depression, suicidal ideation, self-harm, depression, life changes, school challenges, self-esteem, etc.
(434) 474-2473 View (434) 474-2473
Photo of Barbara M Brown - Barbara M. Brown, Psychotherapist, LPC, LMFT, Psychot, Marriage & Family Therapist
Barbara M. Brown, Psychotherapist
Marriage & Family Therapist, LPC, LMFT, Psychot
Verified Verified
Cape Charles, VA 23310  (Online Only)
As a psychotherapist in full-time practice for over 30 years, I take an integrated approach to therapy. I’m trained in Cognitive Behavioral Therapy, Emotional Focused Therapy, Family Therapy, and mindfulness practices. Therapy can help you get unstuck. Whether you are dealing with difficult relationship issues, individual worries, fears, lack of confidence, or unresolved issues, it is possible to move forward and change your life.
As a psychotherapist in full-time practice for over 30 years, I take an integrated approach to therapy. I’m trained in Cognitive Behavioral Therapy, Emotional Focused Therapy, Family Therapy, and mindfulness practices. Therapy can help you get unstuck. Whether you are dealing with difficult relationship issues, individual worries, fears, lack of confidence, or unresolved issues, it is possible to move forward and change your life.
(757) 941-5625 View (757) 941-5625
Photo of Amy E Couch - Shore Therapy, LLC, LPC, CSOTP, LSAT, Licensed Professional Counselor
Shore Therapy, LLC
Licensed Professional Counselor, LPC, CSOTP, LSAT
Verified Verified
Cape Charles, VA 23310
I am a Culturally competent Psychotherapist with over 15 years of experience working with diverse populations providing treatment using various evidence-based, person-centered treatment modalities. I do not believe in stigmatizing or judging people, nor do I believe that people "are" their diagnosis. I believe that the relationship between client and therapist is one of the most important tools of change, so I strive to create a safe space where the client feels free to be their authentic self. I have experience working with individuals, groups, couples, polyamorous, unions, and justice involved clients.
I am a Culturally competent Psychotherapist with over 15 years of experience working with diverse populations providing treatment using various evidence-based, person-centered treatment modalities. I do not believe in stigmatizing or judging people, nor do I believe that people "are" their diagnosis. I believe that the relationship between client and therapist is one of the most important tools of change, so I strive to create a safe space where the client feels free to be their authentic self. I have experience working with individuals, groups, couples, polyamorous, unions, and justice involved clients.
(757) 801-3797 View (757) 801-3797
Photo of Andrea Graziano, LPC, Licensed Professional Counselor
Andrea Graziano
Licensed Professional Counselor, LPC
Verified Verified
Belle Haven, VA 23306
My name is Andrea Graziano, and I am a Licensed Professional Counselor (LPC) in the Commonwealth of Virginia. I work with adults to help ameliorate symptoms of anxiety, depression, and relationship issues using Cognitive Behavioral Therapy and Person-Centered Therapy. I have found that adults grappling with anxiety, depression, and relationship issues feel empowered when they are able to shed old thoughts and habits. Clients feel better about themselves and develop a more positive outlook as a result of building new skills.
My name is Andrea Graziano, and I am a Licensed Professional Counselor (LPC) in the Commonwealth of Virginia. I work with adults to help ameliorate symptoms of anxiety, depression, and relationship issues using Cognitive Behavioral Therapy and Person-Centered Therapy. I have found that adults grappling with anxiety, depression, and relationship issues feel empowered when they are able to shed old thoughts and habits. Clients feel better about themselves and develop a more positive outlook as a result of building new skills.
(804) 455-9013 View (804) 455-9013
Photo of Katie Wendell, MEd, NCC
Katie Wendell
Resident in Counseling, MEd, NCC
Verified Verified
4 Endorsed
Cape Charles, VA 23310
I believe that you are the author of your own story, perhaps a story you're still searching for. My role is to assist you in bringing this story into awareness and support you as you write the next chapter, allowing you to step into your full potential as your most authentic self. This, of course, looks different for each person. Perhaps you are ready to process past experiences, strengthen coping mechanisms, develop healthier thinking patterns, or break negative relationship cycles. Whatever your needs may look like, I can be your guide towards such healing.
I believe that you are the author of your own story, perhaps a story you're still searching for. My role is to assist you in bringing this story into awareness and support you as you write the next chapter, allowing you to step into your full potential as your most authentic self. This, of course, looks different for each person. Perhaps you are ready to process past experiences, strengthen coping mechanisms, develop healthier thinking patterns, or break negative relationship cycles. Whatever your needs may look like, I can be your guide towards such healing.
(757) 330-4184 View (757) 330-4184
Photo of Kelly Conner, Pre-Licensed Professional
Kelly Conner
Pre-Licensed Professional
Verified Verified
Keller, VA 23401
I am Kelly Conner, a resident in counseling with over a year of experience. I have more than 10 years of experience in the mental health field working with both children and adults. I specialize in treating kids on the autism spectrum, as well as issues related to divorce, anxiety, depression, PTSD, ADHD, sensory processing disorders, and OCD diagnoses. My background as a registered behavior technician (RBT) for ABA therapy has equipped me to support children on the autism spectrum effectively. I also bring a creative approach to help children and families discover new perspectives and techniques tailored to each individual.
I am Kelly Conner, a resident in counseling with over a year of experience. I have more than 10 years of experience in the mental health field working with both children and adults. I specialize in treating kids on the autism spectrum, as well as issues related to divorce, anxiety, depression, PTSD, ADHD, sensory processing disorders, and OCD diagnoses. My background as a registered behavior technician (RBT) for ABA therapy has equipped me to support children on the autism spectrum effectively. I also bring a creative approach to help children and families discover new perspectives and techniques tailored to each individual.
(757) 982-9742 View (757) 982-9742
Photo of Amelia Jacokes, LCSW, Clinical Social Work/Therapist
Amelia Jacokes
Clinical Social Work/Therapist, LCSW
Verified Verified
Melfa, VA 23410
Do you want to learn more about yourself and how you walk through life? Do you experience difficulties in areas that others seem to have a relatively easy time managing? I’m a licensed clinical social worker in Virginia and California (license numbers: VA: 0904013582, CA: 99619). I spent my internship years working with dementia patients as well as gaining experience with the chronic pain population. By working in the intensive outpatient program environment,
Do you want to learn more about yourself and how you walk through life? Do you experience difficulties in areas that others seem to have a relatively easy time managing? I’m a licensed clinical social worker in Virginia and California (license numbers: VA: 0904013582, CA: 99619). I spent my internship years working with dementia patients as well as gaining experience with the chronic pain population. By working in the intensive outpatient program environment,
(757) 517-8409 View (757) 517-8409
Photo of Nicole Wynder - Life Domains and Eudaimonia Tessellation Center, EdD, LPC, LMFT, LSATP, NCC, Licensed Professional Counselor
Life Domains and Eudaimonia Tessellation Center
Licensed Professional Counselor, EdD, LPC, LMFT, LSATP, NCC
Verified Verified
1 Endorsed
Cape Charles, VA 23310  (Online Only)
The first step towards figuring out what is wrong is getting in touch with your life domains—exploring different aspects of life we experience through living well and covering all the surfaces. As an innovative therapist, I can help you work through these tough times in the comfort of your personal space. I have experience working with adults and couples. As a professional mental health care provider, I am familiar with animal-assisted therapies. I can help you get a certification for your pet or locate a program or animal that is right for you.
The first step towards figuring out what is wrong is getting in touch with your life domains—exploring different aspects of life we experience through living well and covering all the surfaces. As an innovative therapist, I can help you work through these tough times in the comfort of your personal space. I have experience working with adults and couples. As a professional mental health care provider, I am familiar with animal-assisted therapies. I can help you get a certification for your pet or locate a program or animal that is right for you.
(757) 330-1780 View (757) 330-1780
Photo of Shaena Wiggins, LCSW, Clinical Social Work/Therapist
Shaena Wiggins
Clinical Social Work/Therapist, LCSW
Verified Verified
Exmore, VA 23350
My name is Shaena Wiggins and I am a Licensed Clinical Social Worker (LCSW) based in Hampton Roads, Virginia and working with clients statewide via telehealth. I work with adults and specialize in anxiety, depression, stress, and weight-related concerns to include bariatric surgery patients, using Cognitive Behavioral Therapy and Acceptance and Commitment Therapy to help my clients make progress and start feeling better.
My name is Shaena Wiggins and I am a Licensed Clinical Social Worker (LCSW) based in Hampton Roads, Virginia and working with clients statewide via telehealth. I work with adults and specialize in anxiety, depression, stress, and weight-related concerns to include bariatric surgery patients, using Cognitive Behavioral Therapy and Acceptance and Commitment Therapy to help my clients make progress and start feeling better.
(757) 844-5060 View (757) 844-5060
Photo of Eraina H Smith, Pre-Licensed Professional
Eraina H Smith
Pre-Licensed Professional
Verified Verified
Franktown, VA 23354
I am a Registered Mental Health Counseling Intern (RMHC-I) with over 2 years of experience in the mental health field. I am passionate about helping children, teens, parents, and families address their unique challenges and live more fulfilled lives. I specialize in working with autism, anxiety, anger, behavioral issues, and parenting struggles.
I am a Registered Mental Health Counseling Intern (RMHC-I) with over 2 years of experience in the mental health field. I am passionate about helping children, teens, parents, and families address their unique challenges and live more fulfilled lives. I specialize in working with autism, anxiety, anger, behavioral issues, and parenting struggles.
(904) 529-0503 View (904) 529-0503
Photo of Alexa Allen, MSEd, Pre-Licensed Professional
Alexa Allen
Pre-Licensed Professional, MSEd
Verified Verified
Cape Charles, VA 23310
Seeking therapy can be an overwhelming experience. My focus is to help you feel as comfortable and supported as possible while we navigate the therapeutic process. I believe the therapeutic relationship is the backbone of the counseling experience. As such, I strive to provide a safe, welcoming, and compassionate environment to best support your individual needs and growth. Whether you are looking for a space to process and cope with life’s stressors or striving to change unhelpful patterns and behaviors, I hope to provide the space and tools necessary to help you meet your goals.
Seeking therapy can be an overwhelming experience. My focus is to help you feel as comfortable and supported as possible while we navigate the therapeutic process. I believe the therapeutic relationship is the backbone of the counseling experience. As such, I strive to provide a safe, welcoming, and compassionate environment to best support your individual needs and growth. Whether you are looking for a space to process and cope with life’s stressors or striving to change unhelpful patterns and behaviors, I hope to provide the space and tools necessary to help you meet your goals.
(757) 586-4188 View (757) 586-4188
Photo of Amber Shreve, LPC, Licensed Professional Counselor
Amber Shreve
Licensed Professional Counselor, LPC
Verified Verified
Belle Haven, VA 23306  (Online Only)
Are you feeling stuck? Trapped in a cycle that keeps you from living the life you want to live? Feeling overwhelmed, out of control or hopeless? Maybe you are doing well and looking to maintain life balance or accelerate success in relationships or vocation. Let's break through the barriers holding you back! Learn how to live your best life. Together, we will identify your strengths used to bring you this far and you will gain perspective on the patterns you want to change. At every step, you will be in control.
Are you feeling stuck? Trapped in a cycle that keeps you from living the life you want to live? Feeling overwhelmed, out of control or hopeless? Maybe you are doing well and looking to maintain life balance or accelerate success in relationships or vocation. Let's break through the barriers holding you back! Learn how to live your best life. Together, we will identify your strengths used to bring you this far and you will gain perspective on the patterns you want to change. At every step, you will be in control.
(757) 210-7895 View (757) 210-7895
Photo of Yvonne-da Copeland, LCSW, Clinical Social Work/Therapist
Yvonne-da Copeland
Clinical Social Work/Therapist, LCSW
Verified Verified
Cape Charles, VA 23310
Hello! I have been a licensed clinical social worker and psychotherapist for 15 years. I specialize in working with issues like anger management, anxiety, depression, coping skills, and stress. I’ve worked with the general population, as well as specific groups such as veterans and those with severe mental illnesses. I use evidence-based techniques and incorporate Christian Counseling, Cognitive Behavioral Therapy, Narrative, Motivational Interviewing, Psychodynamic, and more. Whether you’re grappling with the consequences of the pandemic, ever-present psychosocial stressors, or unresolved issues of the past, therapy can help.
Hello! I have been a licensed clinical social worker and psychotherapist for 15 years. I specialize in working with issues like anger management, anxiety, depression, coping skills, and stress. I’ve worked with the general population, as well as specific groups such as veterans and those with severe mental illnesses. I use evidence-based techniques and incorporate Christian Counseling, Cognitive Behavioral Therapy, Narrative, Motivational Interviewing, Psychodynamic, and more. Whether you’re grappling with the consequences of the pandemic, ever-present psychosocial stressors, or unresolved issues of the past, therapy can help.
(571) 497-5661 View (571) 497-5661
Photo of Catherine Medina, LCSW, Clinical Social Work/Therapist
Catherine Medina
Clinical Social Work/Therapist, LCSW
Verified Verified
Birdsnest, VA 23307
Hi! My name is Catherine Medina, and I am a Licensed Clinical Social Worker practicing in Virginia. My goal is to assist people in living their most fulfilling life by resolving the issues that stand in their way. I have extensive clinical training and experience, and I am excited to make a positive difference in your life! I primarily work with adults and couples. I have extensive experience with adults of all ages and with newlyweds as well as people in long-term relationships. My experience is primarily in treating mood, anxiety, trauma, self-esteem, and relationship issues.
Hi! My name is Catherine Medina, and I am a Licensed Clinical Social Worker practicing in Virginia. My goal is to assist people in living their most fulfilling life by resolving the issues that stand in their way. I have extensive clinical training and experience, and I am excited to make a positive difference in your life! I primarily work with adults and couples. I have extensive experience with adults of all ages and with newlyweds as well as people in long-term relationships. My experience is primarily in treating mood, anxiety, trauma, self-esteem, and relationship issues.
(757) 690-2136 View (757) 690-2136
Photo of James Willie Jenkins, LPC, ACS, LMHP, Licensed Professional Counselor
James Willie Jenkins
Licensed Professional Counselor, LPC, ACS, LMHP
Verified Verified
1 Endorsed
Cape Charles, VA 23310  (Online Only)
I am a solution focused Licensed Professional Counselor with over 10 years of experience working in both rural and metropolitan locations. It is my hopes to provide a supportive safe space to assist you in making progress towards your goals. I have extensive experience working with children, adolescents, and adults. I also have 5 years of experience working closely with active duty military and their dependents.
I am a solution focused Licensed Professional Counselor with over 10 years of experience working in both rural and metropolitan locations. It is my hopes to provide a supportive safe space to assist you in making progress towards your goals. I have extensive experience working with children, adolescents, and adults. I also have 5 years of experience working closely with active duty military and their dependents.
(804) 656-5373 View (804) 656-5373
Photo of Damara Beckett, LPC, Licensed Professional Counselor
Damara Beckett
Licensed Professional Counselor, LPC
Verified Verified
Melfa, VA 23410
Hello, my name is Damara Beckett, Lpc, Csac. As a clinician, I meet clients where they are and walk alongside them as they become better versions of themselves. I specialize in substance use and general mental health treatment of those ages 13-99 years old. I have a vast array of treating individuals with substance use disorder and general mental health conditions. The most common theoretical approach of my work is cognitive behavior. I work with individuals to explore how their thinking can change feelings and behaviors, thus creating a more favorable outcome.
Hello, my name is Damara Beckett, Lpc, Csac. As a clinician, I meet clients where they are and walk alongside them as they become better versions of themselves. I specialize in substance use and general mental health treatment of those ages 13-99 years old. I have a vast array of treating individuals with substance use disorder and general mental health conditions. The most common theoretical approach of my work is cognitive behavior. I work with individuals to explore how their thinking can change feelings and behaviors, thus creating a more favorable outcome.
(757) 797-9520 View (757) 797-9520

See more therapy options for 23405

How does your Therapist compare?

Number of Therapists in 23405

< 10

Therapists in 23405 who prioritize treating:

100% Depression
100% Grief
100% Coping Skills
50% Addiction
50% Chronic Pain
50% Eating Disorders
50% Geriatric and Seniors

Top 3 insurances accepted

100% Aetna
100% BlueCross and BlueShield
100% Cigna and Evernorth

How Therapists in 23405 see their clients

100% In Person and Online

Gender breakdown

50% Female
50% Male
FAQs - About Therapy and Counseling

How can I find a therapist in 23405?

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.