Photo of Rodrigo Caldera, LMFT, Marriage & Family Therapist
Rodrigo Caldera
Marriage & Family Therapist, LMFT
Verified Verified
4 Endorsed
Pacifica, CA 94044
I work with a diverse range of individuals, couples, and families who are experiencing any number of mental health challenges related to anxiety, depression, sexuality, trauma, relationships, and grief, amongst others. I am committed to providing culturally competent, trauma informed care across the spectrum of age, race, gender, sexuality, religion, and background.
I work with a diverse range of individuals, couples, and families who are experiencing any number of mental health challenges related to anxiety, depression, sexuality, trauma, relationships, and grief, amongst others. I am committed to providing culturally competent, trauma informed care across the spectrum of age, race, gender, sexuality, religion, and background.
(650) 648-4144 View (650) 648-4144
Photo of Rafael Portuges, LMFT, Marriage & Family Therapist
Rafael Portuges
Marriage & Family Therapist, LMFT
Verified Verified
1 Endorsed
Pacifica, CA 94044
As a Licensed Marriage and Family Therapist (LMFT), my mission is to provide compassionate and effective therapy to individuals, couples, and families with a variety of challenges. I believe in the power of therapy as a collaborative process, where clients are empowered to explore their thoughts, emotions, and behaviors in a safe and supportive environment. My approach is rooted in empathy, respect, and cultural sensitivity, recognizing that each person's experiences and perspectives are unique. I strive to create a therapeutic relationship built on trust and authenticity.
As a Licensed Marriage and Family Therapist (LMFT), my mission is to provide compassionate and effective therapy to individuals, couples, and families with a variety of challenges. I believe in the power of therapy as a collaborative process, where clients are empowered to explore their thoughts, emotions, and behaviors in a safe and supportive environment. My approach is rooted in empathy, respect, and cultural sensitivity, recognizing that each person's experiences and perspectives are unique. I strive to create a therapeutic relationship built on trust and authenticity.
(650) 360-9881 View (650) 360-9881
Photo of Tia Huston, MS, LCAT, BC-DMT, Art Therapist
Tia Huston
Art Therapist, MS, LCAT, BC-DMT
Verified Verified
4 Endorsed
Pacifica, CA 94044  (Online Only)
Not accepting new clients
As a dance/movement therapist, our sessions can be purely talk therapy, movement and talk therapy, or a mixture of movement, talk, and other creative approaches. In our sessions together, I will create a space where all aspects of you are welcome and you can speak freely about whatever is on your mind. I can help you understand how your past impacts your present. I am here to listen, understand, and help you discover new choices and new ways of being, so that you can flourish in life. I am here to support you on your journey of self discovery and self growth.
As a dance/movement therapist, our sessions can be purely talk therapy, movement and talk therapy, or a mixture of movement, talk, and other creative approaches. In our sessions together, I will create a space where all aspects of you are welcome and you can speak freely about whatever is on your mind. I can help you understand how your past impacts your present. I am here to listen, understand, and help you discover new choices and new ways of being, so that you can flourish in life. I am here to support you on your journey of self discovery and self growth.
(415) 226-4203 View (415) 226-4203
Photo of Victoria Holley, MA, LMFT, Marriage & Family Therapist
Victoria Holley
Marriage & Family Therapist, MA, LMFT
Verified Verified
Pacifica, CA 94044
Not accepting new clients
Hi, I'm Victoria! My focus is working with children ages 6+, adolescents, teenagers and women - specifically moms and moms of multiples. I help with a variety of issues, primarily anxiety, social anxiety, depression, stress, life transitions, and those struggling with finding or rediscovering identity and authenticity. I believe humans strive to be the best they can be, and are always on the path to self-actualization. You are the expert in your life, but sometimes there is a disconnect between where you are and where you want to be. I will help guide you to get there and together, we will work towards your goals.
Hi, I'm Victoria! My focus is working with children ages 6+, adolescents, teenagers and women - specifically moms and moms of multiples. I help with a variety of issues, primarily anxiety, social anxiety, depression, stress, life transitions, and those struggling with finding or rediscovering identity and authenticity. I believe humans strive to be the best they can be, and are always on the path to self-actualization. You are the expert in your life, but sometimes there is a disconnect between where you are and where you want to be. I will help guide you to get there and together, we will work towards your goals.
(650) 582-2740 View (650) 582-2740
Photo of Anyella Clark, MFT, Marriage & Family Therapist
Anyella Clark
Marriage & Family Therapist, MFT
Verified Verified
Pacifica, CA 94044
I HAVE BEEN A LICENSED MARRIAGE AND FAMILY THERAPIST, CHILD-PARENT PSYCHOTHERAPIST AND AN EARLY CHILDHOOD SPECIALIST FOR ALMOST 20 YEAR. I HAVE DEDICATED MY LIFE TO WORKING WITH FAMILIES AND YOUNG CHILDREN TO HELP PARENTS CREATE A LOVING AND HARMONIOUS ENVIRONMENT IN WHICH THEIR CHILDREN CAN THRIVE.
I HAVE BEEN A LICENSED MARRIAGE AND FAMILY THERAPIST, CHILD-PARENT PSYCHOTHERAPIST AND AN EARLY CHILDHOOD SPECIALIST FOR ALMOST 20 YEAR. I HAVE DEDICATED MY LIFE TO WORKING WITH FAMILIES AND YOUNG CHILDREN TO HELP PARENTS CREATE A LOVING AND HARMONIOUS ENVIRONMENT IN WHICH THEIR CHILDREN CAN THRIVE.
(650) 984-1351 View (650) 984-1351
Photo of Beth Bashore, MA, MFT, Marriage & Family Therapist
Beth Bashore
Marriage & Family Therapist, MA, MFT
Verified Verified
Pacifica, CA 94044  (Online Only)
Change is stressful, even when it comes with joy or success, or when you’ve worked toward it for a long time. It’s natural to have lots of emotions or even doubts arise in times of transition. Promotions, new relationships, moves, the death of a friend or loved one or beloved pet, relationships ending, moving into a new stage of life - change always involves elements of the unknown. For over 20 years I’ve been helping people navigate life transitions. I meet each client where they are, to help them grow and develop in ways that help them through challenging times.
Change is stressful, even when it comes with joy or success, or when you’ve worked toward it for a long time. It’s natural to have lots of emotions or even doubts arise in times of transition. Promotions, new relationships, moves, the death of a friend or loved one or beloved pet, relationships ending, moving into a new stage of life - change always involves elements of the unknown. For over 20 years I’ve been helping people navigate life transitions. I meet each client where they are, to help them grow and develop in ways that help them through challenging times.
(415) 799-7412 View (415) 799-7412
Suzanne M Valla
Marriage & Family Therapist, LMFT
Verified Verified
Pacifica, CA 94044
I specialize working with young adults parents and other adults who are experiencing life transitions-such as, grief and loss issues, anxiety and depression. Mindfulness and Cognitive Behavioral techniques are taught to my clients as they work toward recovery and acceptance while receiving positive regard and support.
I specialize working with young adults parents and other adults who are experiencing life transitions-such as, grief and loss issues, anxiety and depression. Mindfulness and Cognitive Behavioral techniques are taught to my clients as they work toward recovery and acceptance while receiving positive regard and support.
(415) 930-9318 View (415) 930-9318
Photo of Fritz Bixler, AMFT, APCC, Marriage & Family Therapist Associate
Fritz Bixler
Marriage & Family Therapist Associate, AMFT, APCC
Verified Verified
2 Endorsed
Pacifica, CA 94044
My priority is helping you build a life beyond your wildest dreams. I am dedicated to meeting you where you’re at, and supporting you in carving out your own unique path towards healing and self-actualization. I believe everyone has the capacity to flourish, and I aim to create space for my clients to explore what wellness looks like for them. I really get intensity and emotional sensitivity, and understand the blessings and burdens that come with diverse ways of seeing the world. I am primarily a drama therapist specializing in creative play, but also provide straightforward talk therapy.
My priority is helping you build a life beyond your wildest dreams. I am dedicated to meeting you where you’re at, and supporting you in carving out your own unique path towards healing and self-actualization. I believe everyone has the capacity to flourish, and I aim to create space for my clients to explore what wellness looks like for them. I really get intensity and emotional sensitivity, and understand the blessings and burdens that come with diverse ways of seeing the world. I am primarily a drama therapist specializing in creative play, but also provide straightforward talk therapy.
(925) 966-3435 View (925) 966-3435
Photo of Aliza Shelan, MA, MFT, Marriage & Family Therapist
Aliza Shelan
Marriage & Family Therapist, MA, MFT
Verified Verified
Pacifica, CA 94044
Teen angst? Bring it on! I work with adolescents, teens, and parents in navigating some of the most difficult years. If you are having difficulty connecting with your child, tween, or teen I will assist you with enhancing your connection while simultaneously setting boundaries as a parent. Sounds like a difficult feat? I know! But isn't it from the challenging times that we gain the most? Do you remember what it was like getting through middle school? Many of us would like to forget, however, with assistance it does not have to be so difficult for your child or for you to reach them.
Teen angst? Bring it on! I work with adolescents, teens, and parents in navigating some of the most difficult years. If you are having difficulty connecting with your child, tween, or teen I will assist you with enhancing your connection while simultaneously setting boundaries as a parent. Sounds like a difficult feat? I know! But isn't it from the challenging times that we gain the most? Do you remember what it was like getting through middle school? Many of us would like to forget, however, with assistance it does not have to be so difficult for your child or for you to reach them.
(628) 400-0314 View (628) 400-0314
Photo of Patricia A Luken, MFT, RN, CDE, Marriage & Family Therapist
Patricia A Luken
Marriage & Family Therapist, MFT, RN, CDE
Verified Verified
Pacifica, CA 94044
Not accepting new clients
So you are looking for a therapist and I am happy that you have found my page. I know this is not an easy decision for you to consider coming to therapy. Therapy is a very individualized process and finding the right therapist for yourself is important. I conceptualize therapy as a collaborative process in which the therapist and client(s) work together to develop treatment content and goals. I can and do work in a solution-oriented fashion but can also go further beyond symptom relief to help clients create lasting change in their lives.
So you are looking for a therapist and I am happy that you have found my page. I know this is not an easy decision for you to consider coming to therapy. Therapy is a very individualized process and finding the right therapist for yourself is important. I conceptualize therapy as a collaborative process in which the therapist and client(s) work together to develop treatment content and goals. I can and do work in a solution-oriented fashion but can also go further beyond symptom relief to help clients create lasting change in their lives.
(925) 523-7364 View (925) 523-7364
Photo of Jeffrey Joseph Bruno, PhD, Psychologist
Jeffrey Joseph Bruno
Psychologist, PhD
Verified Verified
Pacifica, CA 94044
My clients seek integrative solutions to complex and distressful problems for their own or their children's thoughts, emotions, and bodily experiences. While talk-based therapies are helpful, a relational approach may not be enough to solve acute or chronic mental health challenges. Yet, anxiety, depression, insomnia, OCD, PTSD, or developmental-learning disabilities often respond to personalized and holistic mind-body approaches. My ideal client is looking for more than an expert to talk with about their challenges or symptoms. They are open to exploring new methods and strategies to beneficially transform their life.
My clients seek integrative solutions to complex and distressful problems for their own or their children's thoughts, emotions, and bodily experiences. While talk-based therapies are helpful, a relational approach may not be enough to solve acute or chronic mental health challenges. Yet, anxiety, depression, insomnia, OCD, PTSD, or developmental-learning disabilities often respond to personalized and holistic mind-body approaches. My ideal client is looking for more than an expert to talk with about their challenges or symptoms. They are open to exploring new methods and strategies to beneficially transform their life.
(650) 675-3703 View (650) 675-3703
Photo of Cassandra Majus - Cassandra Majus, MFT, MFT, LPCC, Marriage & Family Therapist
Cassandra Majus, MFT
Marriage & Family Therapist, MFT, LPCC
Verified Verified
2 Endorsed
Pacifica, CA 94044
Life is full of transitions, whether in childhood or adulthood. They are part of life and can be positive or negative. Life will always throw something your way. I'd like to help you through these transitional periods and make the journey smooth and comfortable. Seeking treatment can be a difficult choice, but in the end is a rewarding part of life. I'm looking to support parents of young children, children/teens transitioning to new stages of life, adolescents transitioning to college, new mothers adjusting to being a parent, and women who are struggling with job/school/relationship/motherhood stressors.
Life is full of transitions, whether in childhood or adulthood. They are part of life and can be positive or negative. Life will always throw something your way. I'd like to help you through these transitional periods and make the journey smooth and comfortable. Seeking treatment can be a difficult choice, but in the end is a rewarding part of life. I'm looking to support parents of young children, children/teens transitioning to new stages of life, adolescents transitioning to college, new mothers adjusting to being a parent, and women who are struggling with job/school/relationship/motherhood stressors.
(650) 204-8690 View (650) 204-8690
Photo of Heidi Pidcoke, LMFT, MA, Marriage & Family Therapist
Heidi Pidcoke
Marriage & Family Therapist, LMFT, MA
Verified Verified
Pacifica, CA 94044
Sometimes in life we experience seasons of feeling adrift and lost. Other times we have faced immensely painful circumstances which have left a lingering impact on our thoughts, mood and behavior. Working together we can illuminate pathways to resolve these challenges and reach a sense of safety, connection and purpose. As a Somatic Psychotherapist, I specialize in restoring a mind/body connection along with focusing on overcoming the distress caused by a sudden transition, loss, violence, burnout and betrayal.
Sometimes in life we experience seasons of feeling adrift and lost. Other times we have faced immensely painful circumstances which have left a lingering impact on our thoughts, mood and behavior. Working together we can illuminate pathways to resolve these challenges and reach a sense of safety, connection and purpose. As a Somatic Psychotherapist, I specialize in restoring a mind/body connection along with focusing on overcoming the distress caused by a sudden transition, loss, violence, burnout and betrayal.
(626) 314-5517 View (626) 314-5517
Photo of Samantha Howard, LMFT, Marriage & Family Therapist
Samantha Howard
Marriage & Family Therapist, LMFT
Verified Verified
Pacifica, CA 94044
Do you find yourself needing extra support as summer is approaching? I recognize the courage it takes to seek support in your life journey. I strive to provide a non-judgmental and safe place for individuals as growth can begin where it feels safe. I am compassionate in helping my clients define, identify, and practice self-compassion along their journey. Together, we can identify and process areas of discomfort, practice self-regulation and coping skills, and reframe negative thought patterns.
Do you find yourself needing extra support as summer is approaching? I recognize the courage it takes to seek support in your life journey. I strive to provide a non-judgmental and safe place for individuals as growth can begin where it feels safe. I am compassionate in helping my clients define, identify, and practice self-compassion along their journey. Together, we can identify and process areas of discomfort, practice self-regulation and coping skills, and reframe negative thought patterns.
(650) 675-2174 View (650) 675-2174
Photo of Mollie Yocum, LCSW, LICSW, Clinical Social Work/Therapist
Mollie Yocum
Clinical Social Work/Therapist, LCSW, LICSW
Verified Verified
Pacifica, CA 94044
Are you struggling with navigating a relationship in your life? Relational therapy, typically called couples but can include a variety of relationship types, focuses in on communication, trust, repair, and joy. Typical sessions include allowing space for identifying specific sources of discomfort and practice for how to make and sustain relational shifts. Specialized training in child psychology allows for particular support around navigating parenting challenges and understanding how to support your unique child.
Are you struggling with navigating a relationship in your life? Relational therapy, typically called couples but can include a variety of relationship types, focuses in on communication, trust, repair, and joy. Typical sessions include allowing space for identifying specific sources of discomfort and practice for how to make and sustain relational shifts. Specialized training in child psychology allows for particular support around navigating parenting challenges and understanding how to support your unique child.
(650) 547-0943 View (650) 547-0943
Photo of Rachel Holowicki, MEd, EdS, LEP
Rachel Holowicki
Licensed Educational Psychologist, MEd, EdS, LEP
Verified Verified
Pacifica, CA 94044
I feel incredibly fortunate to have the ability to help children and families understand and navigate learning differences and disabilities. The special education/IEP process can be overwhelming, and I am happy to help guide you and your family to make the best decisions for your child. I truly believe every child can be successful, and it's so rewarding to help children reach their full potential. I work often with children with learning disabilities like dyslexia, ADHD, Autism, and intellectual and developmental disabilities.
I feel incredibly fortunate to have the ability to help children and families understand and navigate learning differences and disabilities. The special education/IEP process can be overwhelming, and I am happy to help guide you and your family to make the best decisions for your child. I truly believe every child can be successful, and it's so rewarding to help children reach their full potential. I work often with children with learning disabilities like dyslexia, ADHD, Autism, and intellectual and developmental disabilities.
(415) 592-7875 View (415) 592-7875
Photo of Christina Marie Balistreri, MS, LMFT, Marriage & Family Therapist
Christina Marie Balistreri
Marriage & Family Therapist, MS, LMFT
Verified Verified
1 Endorsed
Pacifica, CA 94044  (Online Only)
I have worked with a wide variety of clients dealing with a range of symptoms. I enjoy working with different clients from adults to kids and individual, families, couples and groups and I believe we can all learn from each other. I enjoy offering my experiences and skills to help others better understand themselves and their relationships. I understand that life challenges, both big and small, can affect people's mood and productivity. I am caring, compassionate, understanding and a great listener. I provide a very non-judgmental and caring space for clients to explore the challenges they are faced with.
I have worked with a wide variety of clients dealing with a range of symptoms. I enjoy working with different clients from adults to kids and individual, families, couples and groups and I believe we can all learn from each other. I enjoy offering my experiences and skills to help others better understand themselves and their relationships. I understand that life challenges, both big and small, can affect people's mood and productivity. I am caring, compassionate, understanding and a great listener. I provide a very non-judgmental and caring space for clients to explore the challenges they are faced with.
(415) 855-7947 View (415) 855-7947
Photo of Annette M Taylor, MA, MFT, LPCC, Marriage & Family Therapist
Annette M Taylor
Marriage & Family Therapist, MA, MFT, LPCC
Verified Verified
Pacifica, CA 94044
I am now accepting new clients. I work with clients to explore past experiences and life transitions that are affecting their lives. Through weekly sessions, we will work through self exploration, personal concerns and life challenges. We will explore circumstances that can be changed, those that cannot be changed, and how to discern the difference. We will also discuss and practice various coping mechanisms that can help clients improve their lives. Therapy is a gift to yourself!
I am now accepting new clients. I work with clients to explore past experiences and life transitions that are affecting their lives. Through weekly sessions, we will work through self exploration, personal concerns and life challenges. We will explore circumstances that can be changed, those that cannot be changed, and how to discern the difference. We will also discuss and practice various coping mechanisms that can help clients improve their lives. Therapy is a gift to yourself!
(415) 236-3998 View (415) 236-3998
Photo of Maryam Taghdimi, PhD, Psychologist
Maryam Taghdimi
Psychologist, PhD
Verified Verified
Pacifica, CA 94044  (Online Only)
I am a licensed clinical psychotherapist providing individual and group therapy in English, and Persian/Farsi. My clinical areas of interest and areas of expertise include codependency, trauma and complex trauma, substance use, narcissistic abuse, mood & anxiety disorders.
I am a licensed clinical psychotherapist providing individual and group therapy in English, and Persian/Farsi. My clinical areas of interest and areas of expertise include codependency, trauma and complex trauma, substance use, narcissistic abuse, mood & anxiety disorders.
(650) 664-3585 View (650) 664-3585
Photo of Donna C Rodriguez, LMFT, RSP, Marriage & Family Therapist
Donna C Rodriguez
Marriage & Family Therapist, LMFT, RSP
Verified Verified
Pacifica, CA 94044
For over 20 years, I have worked in urban and suburban schools before transitioning to private practice in 2020. K-5 has been my most recent focus, and have worked with middle and high school students in previous years. I have supported students with anxiety, social and behavioral challenges, mood, grief, and attention difficulties. Working collaboratively with parents we can help your child feel a sense of belonging, uncover the frustrations and worry, relieve symptoms of anxiety, and reduce the anger and behavioral challenges using a strength-based approach. I'm here to help!
For over 20 years, I have worked in urban and suburban schools before transitioning to private practice in 2020. K-5 has been my most recent focus, and have worked with middle and high school students in previous years. I have supported students with anxiety, social and behavioral challenges, mood, grief, and attention difficulties. Working collaboratively with parents we can help your child feel a sense of belonging, uncover the frustrations and worry, relieve symptoms of anxiety, and reduce the anger and behavioral challenges using a strength-based approach. I'm here to help!
(650) 376-8751 View (650) 376-8751

How does your Therapist compare?

Number of Therapists in 94044

90+

Average cost per session

$175

Therapists in 94044 who prioritize treating:

93% Anxiety
82% Depression
73% Self Esteem
69% Relationship Issues
68% Coping Skills
64% Stress
61% Trauma and PTSD

Average years in practice

13 Years

Top 3 insurances accepted

73% Cigna and Evernorth
73% UnitedHealthcare UHC | UBH
70% Aetna

How Therapists in 94044 see their clients

79% In Person and Online
21% Online Only

Gender breakdown

86% Female
12% Male
2% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in 94044?

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.