Photo of Kenneth Trivison, LPCC, IMFT
Kenneth Trivison
Licensed Professional Clinical Counselor, LPCC, IMFT
Verified Verified
Ken Trivison earned his master's degree in educational psychology from John Carroll University and completed a two year post-graduate training program in systemic marriage and family therapy. He received his bachelor's degree from the University of Notre Dame. He is a clinical member of the American Association for Marriage and Family Therapy (AAMFT). He has served as a Board member of AAMFT and is a past president of the Ohio Division of AAMFT.
Ken Trivison earned his master's degree in educational psychology from John Carroll University and completed a two year post-graduate training program in systemic marriage and family therapy. He received his bachelor's degree from the University of Notre Dame. He is a clinical member of the American Association for Marriage and Family Therapy (AAMFT). He has served as a Board member of AAMFT and is a past president of the Ohio Division of AAMFT.
(440) 762-6274 View (440) 762-6274
Photo of Jessie Caraballo-Long, LSW, Clinical Social Work/Therapist
Jessie Caraballo-Long
Clinical Social Work/Therapist, LSW
Verified Verified
Hello, I am a dedicated licensed social worker therapist specializing in marriage counseling and child therapy. I have a profound belief that children are the cornerstone of our future, and I am passionate about equipping them with essential mental and emotional tools for success. I begin services with children who are at least 2.5 years old and focus on parent child relationships. My comprehensive services encompass individual, family, and couples counseling, tailored to meet diverse needs. Additionally, I offer biblical-based counseling for Christian clients, ensuring a holistic approach to mental well-being and personal growth.
Hello, I am a dedicated licensed social worker therapist specializing in marriage counseling and child therapy. I have a profound belief that children are the cornerstone of our future, and I am passionate about equipping them with essential mental and emotional tools for success. I begin services with children who are at least 2.5 years old and focus on parent child relationships. My comprehensive services encompass individual, family, and couples counseling, tailored to meet diverse needs. Additionally, I offer biblical-based counseling for Christian clients, ensuring a holistic approach to mental well-being and personal growth.
(440) 273-6362 View (440) 273-6362
Photo of Bill Smith, LISW, Clinical Social Work/Therapist
Bill Smith
Clinical Social Work/Therapist, LISW
Verified Verified
Bill Smith is a licensed independent therapist in Ohio and Florida and is in the Willoughby hills office seasonally. He has received training at the Milton Erickson Foundation in hypnosis and brief therapy and is a member of the American Society of Clinical Hypnosis. He has supervised clinical staff and graduate students, trained professionals in family and strategic therapy and has been an adjunct professor in the graduate school at Cleveland State University. His therapy style is problem focused and solution oriented based on the following beliefs: 1.
Bill Smith is a licensed independent therapist in Ohio and Florida and is in the Willoughby hills office seasonally. He has received training at the Milton Erickson Foundation in hypnosis and brief therapy and is a member of the American Society of Clinical Hypnosis. He has supervised clinical staff and graduate students, trained professionals in family and strategic therapy and has been an adjunct professor in the graduate school at Cleveland State University. His therapy style is problem focused and solution oriented based on the following beliefs: 1.
(440) 379-1536 View (440) 379-1536
Photo of Jessica Lieberth, LPCC-S, Counselor
Jessica Lieberth
Counselor, LPCC-S
Verified Verified
Jessica Lieberth specializes in clinical treatment for mental health issues in adults, particularly anxiety and depression, relationship/family issues, OCD, grief, postpartum issues and Christian counseling. She has some training in treating trauma, and has extensive personal interest and learning in healthy diet, exercise, & lifestyle, and the benefits of such on one's mental health. She has worked in both community mental health and private practice, and helped form a counseling agency from the ground up.
Jessica Lieberth specializes in clinical treatment for mental health issues in adults, particularly anxiety and depression, relationship/family issues, OCD, grief, postpartum issues and Christian counseling. She has some training in treating trauma, and has extensive personal interest and learning in healthy diet, exercise, & lifestyle, and the benefits of such on one's mental health. She has worked in both community mental health and private practice, and helped form a counseling agency from the ground up.
(440) 739-7152 View (440) 739-7152
Photo of Richard Alan Brunner - Rick Brunner, PhD, MSW, Psychologist
Rick Brunner
Psychologist, PhD, MSW
Verified Verified
Willoughby, OH 44094
I've had the sincere pleasure of being a therapist for 35 years. Having worked in a variety of settings has prepared me to be able to provide compassionate guidance to people wrestling with mood disorders (anxiety, depression and bi-polar) as well as to those experiencing struggles in their relationships (marital and family). For the past ten years in private practice, I have continued to assist others using a variety of therapeutic approaches: psychodynamic, cognitive-behavioral, relaxation and coping skills, grief therapy and assertiveness training.
I've had the sincere pleasure of being a therapist for 35 years. Having worked in a variety of settings has prepared me to be able to provide compassionate guidance to people wrestling with mood disorders (anxiety, depression and bi-polar) as well as to those experiencing struggles in their relationships (marital and family). For the past ten years in private practice, I have continued to assist others using a variety of therapeutic approaches: psychodynamic, cognitive-behavioral, relaxation and coping skills, grief therapy and assertiveness training.
(440) 827-2518 View (440) 827-2518
Photo of Silke Pagendarm, LPCC, LCDCIII, Counselor
Silke Pagendarm
Counselor, LPCC, LCDCIII
Verified Verified
1 Endorsed
I am a Licensed Professional Clinical and Chemical Dependency Counselor, and have been serving the Cleveland area for over 25 years. I specialize in treating adults and adolescents who exhibit signs of anxiety, stress, post traumatic stress disorder, depression, and a variety of problematic sexual behaviors as well as victim issues. I have experience working with substance abuse and work with individuals whose use has resulted in legal issues. I work with families and teens who have adjustment and behavioral issues. I work with the individual as well as partners, spouses and family members.
I am a Licensed Professional Clinical and Chemical Dependency Counselor, and have been serving the Cleveland area for over 25 years. I specialize in treating adults and adolescents who exhibit signs of anxiety, stress, post traumatic stress disorder, depression, and a variety of problematic sexual behaviors as well as victim issues. I have experience working with substance abuse and work with individuals whose use has resulted in legal issues. I work with families and teens who have adjustment and behavioral issues. I work with the individual as well as partners, spouses and family members.
(440) 925-5008 View (440) 925-5008
Photo of Cynthia (Cindy) Golden Billittier, MSSA, LISW-S, Clinical Social Work/Therapist
Cynthia (Cindy) Golden Billittier
Clinical Social Work/Therapist, MSSA, LISW-S
Verified Verified
I have 30 years of experience working with adolescents, adults, couples and families with a wide range of complex life circumstances. As a social worker, I pride myself in the ability to look at things from a systemic perspective. No one functions in isolation. I am compassionate and committed to my clients to address their individual needs as no one situation duplicates another. I have worked in a variety of settings: hospital, eating disorder specialty center, residential and private practice. I have experience in treating anxiety, depression, feeding and eating disorders, grief, and families and couples under stress.
I have 30 years of experience working with adolescents, adults, couples and families with a wide range of complex life circumstances. As a social worker, I pride myself in the ability to look at things from a systemic perspective. No one functions in isolation. I am compassionate and committed to my clients to address their individual needs as no one situation duplicates another. I have worked in a variety of settings: hospital, eating disorder specialty center, residential and private practice. I have experience in treating anxiety, depression, feeding and eating disorders, grief, and families and couples under stress.
(216) 666-5244 View (216) 666-5244
Photo of Debra Fuentes - Fuentes Counseling Services L.L.C., LPCC-S, LICDCCS, SAP, ACHT, Counselor
Fuentes Counseling Services L.L.C.
Counselor, LPCC-S, LICDCCS, SAP, ACHT
Verified Verified
2 Endorsed
Willoughby, OH 44094
My specialties are working with families, adolescents, individuals, couples, and groups in the areas of mental health and addiction (alcohol & drug, sexual, gambling, internet, etc.,) trauma, abuse, PTSD, legal issues, depression, anxiety, grief, anger management, domestic violence and behavioral management. Substance Abuse Professional (SAP).
My specialties are working with families, adolescents, individuals, couples, and groups in the areas of mental health and addiction (alcohol & drug, sexual, gambling, internet, etc.,) trauma, abuse, PTSD, legal issues, depression, anxiety, grief, anger management, domestic violence and behavioral management. Substance Abuse Professional (SAP).
(440) 683-6122 View (440) 683-6122
Photo of Martha S Flemming, LPCC-s, LICDC, Counselor
Martha S Flemming
Counselor, LPCC-s, LICDC
Verified Verified
Willoughby, OH 44094  (Online Only)
My clients come to me because they are looking for ways to use their strengths to overcome the challenges that life has thrown at them, whether in their individual lives or in their relationships. I help them to deal with depression, anxiety, grief, trauma, addictions, life transitions, and relationship issues of all kinds. I help children, adolescents and adults across the life span to become their best selves and to live the life that they have been designed to have.
My clients come to me because they are looking for ways to use their strengths to overcome the challenges that life has thrown at them, whether in their individual lives or in their relationships. I help them to deal with depression, anxiety, grief, trauma, addictions, life transitions, and relationship issues of all kinds. I help children, adolescents and adults across the life span to become their best selves and to live the life that they have been designed to have.
(216) 925-4453 x12 View (216) 925-4453 x12
Photo of Lara Waldenmaier, MA, LPCC, Counselor
Lara Waldenmaier
Counselor, MA, LPCC
Verified Verified
1 Endorsed
Willoughby, OH 44094  (Online Only)
Waitlist for new clients
Sometimes we all need a safe space to share our stories with a caring and unbiased listener, and I want to provide that for you. I have been in the mental health field for over 20 years and licensed as a Professional Counselor since 2004. With experience working with many different types of people experiencing anxiety, depression, grief, panic, mental and physical illnesses, relationship issues and so on, I am passionate about helping college students, couples, internationals, jobseekers and adults of any age who are seeking emotional healing, mental health, support and direction for their life's struggles and spiritual questions.
Sometimes we all need a safe space to share our stories with a caring and unbiased listener, and I want to provide that for you. I have been in the mental health field for over 20 years and licensed as a Professional Counselor since 2004. With experience working with many different types of people experiencing anxiety, depression, grief, panic, mental and physical illnesses, relationship issues and so on, I am passionate about helping college students, couples, internationals, jobseekers and adults of any age who are seeking emotional healing, mental health, support and direction for their life's struggles and spiritual questions.
(440) 540-5258 View (440) 540-5258
Photo of Sharon R Rosser, MSW, LSW, Clinical Social Work/Therapist
Sharon R Rosser
Clinical Social Work/Therapist, MSW, LSW
Verified Verified
Are you concerned about others and their well-being? Who is concerned about your well-being? Taking care of yourself is the first step to helping others, let me help you on the way to self-care.
Are you concerned about others and their well-being? Who is concerned about your well-being? Taking care of yourself is the first step to helping others, let me help you on the way to self-care.
(440) 530-9180 View (440) 530-9180
Photo of Rachel Cobos, MA, LPCC-S
Rachel Cobos
Licensed Professional Clinical Counselor , MA, LPCC-S
Verified Verified
My therapeutic approach involves working collaboratively with clients to explore concerns and identify solutions using evidence-based interventions such as CBT, Motivational Interviewing and Solution-Focused methods. I aims to empower clients and assist in enhancing self-awareness. As a clinician I am genuine, supportive and direct and hopes to maintain a safe, inviting space for clients to explore their goals. I am trained in EMDR and DBT therapies and have experience working with teens and adults with a variety of diagnoses and clinical concerns.
My therapeutic approach involves working collaboratively with clients to explore concerns and identify solutions using evidence-based interventions such as CBT, Motivational Interviewing and Solution-Focused methods. I aims to empower clients and assist in enhancing self-awareness. As a clinician I am genuine, supportive and direct and hopes to maintain a safe, inviting space for clients to explore their goals. I am trained in EMDR and DBT therapies and have experience working with teens and adults with a variety of diagnoses and clinical concerns.
(440) 970-0873 View (440) 970-0873
Photo of Kate G Nagy - Colors of Seasons LLC, LPCC, MEd, Counselor
Colors of Seasons LLC
Counselor, LPCC, MEd
Verified Verified
1 Endorsed
Willoughby, OH 44094
Currently accepting new clients and am able to get them in the same week as consultation! I provide an an empowering and grounding space where clients can heal from past traumas, explore their identities, and foster their strengths to their resilience and confidence. I utilize Eye Movement Desensitization and Reprocessing (EMDR) Therapy, a trauma evidenced based approach to explore past and current life stressors. I am passionate about supporting clients, especially women and individuals within the LGBTQIA+ community at all seasons of life as they weather life’s unique challenges.
Currently accepting new clients and am able to get them in the same week as consultation! I provide an an empowering and grounding space where clients can heal from past traumas, explore their identities, and foster their strengths to their resilience and confidence. I utilize Eye Movement Desensitization and Reprocessing (EMDR) Therapy, a trauma evidenced based approach to explore past and current life stressors. I am passionate about supporting clients, especially women and individuals within the LGBTQIA+ community at all seasons of life as they weather life’s unique challenges.
(440) 595-6738 x100 View (440) 595-6738 x100
Photo of Melissa Geiger-Dugandzic, LISW, LICDC, GAMB, Clinical Social Work/Therapist
Melissa Geiger-Dugandzic
Clinical Social Work/Therapist, LISW, LICDC, GAMB
Verified Verified
Willoughby, OH 44094  (Online Only)
Feeling overwhelmed? Unresolved trauma/PTSD, Depressed, anxious or chasing your losses on gambling apps or casinos? Are you using substances to cope with fear or despair. Do you feel like you're on an island with no one to reach out to, or in quicksand and struggling not to get trapped? Pehaps you are a First Responder or veteran seeking help for the first time, and looking for someone to be your "off duty battle buddy. Let's work together to get unstuck! You are not alone! You have taken the first s
Feeling overwhelmed? Unresolved trauma/PTSD, Depressed, anxious or chasing your losses on gambling apps or casinos? Are you using substances to cope with fear or despair. Do you feel like you're on an island with no one to reach out to, or in quicksand and struggling not to get trapped? Pehaps you are a First Responder or veteran seeking help for the first time, and looking for someone to be your "off duty battle buddy. Let's work together to get unstuck! You are not alone! You have taken the first s
(440) 335-6471 View (440) 335-6471
Photo of Timothy Warneka, LPCC-S
Timothy Warneka
Licensed Professional Clinical Counselor, LPCC-S
Verified Verified
With over 25 years of experience providing counseling and psychotherapy services, Mr. Warneka sees men and women, specializing in working with leaders, medical professionals, and mental health professionals. He earned an undergraduate degree from the University of Dayton and his graduate degree from Cleveland State University. He has also completed several extensive post-graduate training programs.
With over 25 years of experience providing counseling and psychotherapy services, Mr. Warneka sees men and women, specializing in working with leaders, medical professionals, and mental health professionals. He earned an undergraduate degree from the University of Dayton and his graduate degree from Cleveland State University. He has also completed several extensive post-graduate training programs.
(440) 762-6294 View (440) 762-6294
Photo of Jennifer N Rauzan, MEd, LPCC
Jennifer N Rauzan
Licensed Professional Clinical Counselor, MEd, LPCC
Verified Verified
**DAY TIME AVAILABILITY ONLY** I believe that change is always possible. My approach is direct and genuine, hopefully insightful, and certainly empathetic. I specialize in working with self harm and suicidal adolescents as well as anxious and depressed adults. I can help you develop effective communication skills, increase your ability to express and handle emotions effectively, to be aware of your needs, and to learn how to resolve conflict successfully.
**DAY TIME AVAILABILITY ONLY** I believe that change is always possible. My approach is direct and genuine, hopefully insightful, and certainly empathetic. I specialize in working with self harm and suicidal adolescents as well as anxious and depressed adults. I can help you develop effective communication skills, increase your ability to express and handle emotions effectively, to be aware of your needs, and to learn how to resolve conflict successfully.
(216) 342-9574 View (216) 342-9574
Photo of Gina Sinito, PCC, ATR
Gina Sinito
Licensed Professional Clinical Counselor, PCC, ATR
Verified Verified
Gina Sinito is a Licensed Counselor in the state of Ohio and Florida, who has been practicing since 1999. She graduated from Cleveland State University with a Master's Degree in Community Agency Counseling and Ursuline College with a Master's Degree in in Art Therapy. Gina believes in a client-centered, cognitive behavioral, mindfulness based approach. Her main areas of focus are anxiety, depression, and codependency. Gina's specialties include, but are not limited to self-esteem, grief and loss, life's transitions, work stress, and burnout. In her spare time, Gina enjoys spending time with her family, walking, and practicing yoga.
Gina Sinito is a Licensed Counselor in the state of Ohio and Florida, who has been practicing since 1999. She graduated from Cleveland State University with a Master's Degree in Community Agency Counseling and Ursuline College with a Master's Degree in in Art Therapy. Gina believes in a client-centered, cognitive behavioral, mindfulness based approach. Her main areas of focus are anxiety, depression, and codependency. Gina's specialties include, but are not limited to self-esteem, grief and loss, life's transitions, work stress, and burnout. In her spare time, Gina enjoys spending time with her family, walking, and practicing yoga.
(440) 737-3708 View (440) 737-3708
Photo of Angela Grey, LPCC, Counselor
Angela Grey
Counselor, LPCC
Verified Verified
Angela Grey has experience working in both inpatient and outpatient settings providing crisis intervention, stabilization and intensive counseling for adults, adolescents and children. She specializes in treating PTSD, anxiety, depression, bipolar disorder, personality disorders, and has extensive experience working with victims of crime, sexual trauma, domestic violence, bullying and narcissistic abuse. A special area of interest is in assisting adolescents with the exploration of gender and sexual identities. Angela uses a client-centered approach, is goal-oriented and believes progress in treatment should be measurable.
Angela Grey has experience working in both inpatient and outpatient settings providing crisis intervention, stabilization and intensive counseling for adults, adolescents and children. She specializes in treating PTSD, anxiety, depression, bipolar disorder, personality disorders, and has extensive experience working with victims of crime, sexual trauma, domestic violence, bullying and narcissistic abuse. A special area of interest is in assisting adolescents with the exploration of gender and sexual identities. Angela uses a client-centered approach, is goal-oriented and believes progress in treatment should be measurable.
(440) 703-6326 View (440) 703-6326
Photo of Evelyn L. Bailey, SWA, MSW, LICDC, Drug & Alcohol Counselor
Evelyn L. Bailey
Drug & Alcohol Counselor, SWA, MSW, LICDC
Verified Verified
Willoughby, OH 44094
Welcome to the world of personal healing! You have taken the first step toward positive changes, and I am so proud of you! My name is Evelyn Bailey and I am excited for the opportunity to meet with you! If you are experiencing stress, anxiety, depression, or everyday life concerns it can leave you feeling as if you are alone. Understanding you are not alone in this walk. There may be challenges we face with jobs, family issues, and loss that can make it difficult to move forward, but let me assure you, that you are in the right place. Together, we will work as a team to develop skills that can be utilized in your everyday life.
Welcome to the world of personal healing! You have taken the first step toward positive changes, and I am so proud of you! My name is Evelyn Bailey and I am excited for the opportunity to meet with you! If you are experiencing stress, anxiety, depression, or everyday life concerns it can leave you feeling as if you are alone. Understanding you are not alone in this walk. There may be challenges we face with jobs, family issues, and loss that can make it difficult to move forward, but let me assure you, that you are in the right place. Together, we will work as a team to develop skills that can be utilized in your everyday life.
(440) 294-6986 x1 View (440) 294-6986 x1
Photo of Phil Flauto, LPCC-S
Phil Flauto
Licensed Professional Clinical Counselor, LPCC-S
Verified Verified
Willoughby, OH 44094
Phil Flauto is a licensed professional clinical counselor with a supervision designation. He holds a bachelor's degree in secondary education from Bowling Green State University and a master's degree in community counseling from Kent State University. He has more than 15 years of experience in behavioral health care and has advanced training in trauma informed care. He works with adolescents and adults, specializing in depression, anxiety, trauma, anger management, relationship issues, grief, attention issues and behavioral problems.
Phil Flauto is a licensed professional clinical counselor with a supervision designation. He holds a bachelor's degree in secondary education from Bowling Green State University and a master's degree in community counseling from Kent State University. He has more than 15 years of experience in behavioral health care and has advanced training in trauma informed care. He works with adolescents and adults, specializing in depression, anxiety, trauma, anger management, relationship issues, grief, attention issues and behavioral problems.
(440) 762-6242 View (440) 762-6242
1

How does your Therapist compare?

Number of Therapists in 44094

100+

Average cost per session

$140

Therapists in 44094 who prioritize treating:

93% Anxiety
91% Depression
77% Self Esteem
76% Trauma and PTSD
72% Relationship Issues
71% Coping Skills
67% Grief

Average years in practice

11 Years

Top 3 insurances accepted

94% Medical Mutual
89% Aetna
85% UnitedHealthcare UHC | UBH

How Therapists in 44094 see their clients

86% In Person and Online
14% Online Only

Gender breakdown

83% Female
17% Male
FAQs - About Therapy and Counseling

How can I find a therapist in 44094?

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.