Therapists in Spokane, WA
![Photo of Andrea Bloom, LMHC, LMFT, Counselor](https://photos.psychologytoday.com/4cf91a30-46cd-11ea-a6ad-06142c356176/1/320x400.jpeg)
Whether you’ve been to counseling before or this is your first time reaching out growth is about being curious…and here you are…being curious. You’re one step closer to being where you want to be.
Whether you’ve been to counseling before or this is your first time reaching out growth is about being curious…and here you are…being curious. You’re one step closer to being where you want to be.
![Photo of Janelle R Engle, MA, LMHC, LPC, Licensed Professional Counselor](https://photos.psychologytoday.com/e4f5c374-5f2a-42a1-8366-9c0c8e836dc9/1/320x400.jpeg)
Janelle R Engle
Licensed Professional Counselor, MA, LMHC, LPC
Verified Verified
2 Endorsed
Spokane, WA 99208 (Online Only)
Counseling can be an adventure in self-discovery, a place to clarify your thoughts and get a fresh perspective about your life. I will help you develop insight into yourself, your life, your relationships and, also, if desired, help you identify specific changes that will bring you a higher quality of life. The better you know yourself, the easier it is to know what you want in life. Finding your own voice and having the confidence to express it is one of the foundational pieces in developing a rich experience in life, and an essential tool in relating to others.
Counseling can be an adventure in self-discovery, a place to clarify your thoughts and get a fresh perspective about your life. I will help you develop insight into yourself, your life, your relationships and, also, if desired, help you identify specific changes that will bring you a higher quality of life. The better you know yourself, the easier it is to know what you want in life. Finding your own voice and having the confidence to express it is one of the foundational pieces in developing a rich experience in life, and an essential tool in relating to others.
![Photo of Teresa Clark-Kincaid - Anchor Counseling Services Spokane, MA, LMFT, LMHC, Marriage & Family Therapist](https://photos.psychologytoday.com/426f9137-46cd-11ea-a6ad-06142c356176/3/320x400.jpeg)
Anchor Counseling Services Spokane
Marriage & Family Therapist, MA, LMFT, LMHC
Verified Verified
3 Endorsed
Spokane, WA 99203
I believe that beginning therapy doesn't mean that something is wrong with you. It can be that safe hour you take to nourish yourself and find clarity. With this self-care it is possible to begin the changes that seemed overwhelming by yourself. Children and adolescents are often surprised to find therapy a fun hour where they enjoy new ways of telling their story and being heard. You don't have to go it alone. Together we can find healing.
I believe that beginning therapy doesn't mean that something is wrong with you. It can be that safe hour you take to nourish yourself and find clarity. With this self-care it is possible to begin the changes that seemed overwhelming by yourself. Children and adolescents are often surprised to find therapy a fun hour where they enjoy new ways of telling their story and being heard. You don't have to go it alone. Together we can find healing.
![Photo of Kalkidan Wilson, MSW, LSWAIC, Clinical Social Work/Therapist](https://photos.psychologytoday.com/3de4fc01-6691-4f09-9654-ca299729776d/1/320x400.jpeg)
Kalkidan Wilson
Clinical Social Work/Therapist, MSW, LSWAIC
Verified Verified
Spokane, WA 99207 (Online Only)
My name is Kalkidan Wilson, but I go by Kali. I am a dedicated and compassionate social worker with a master’s degree from Eastern Washington University. My therapeutic approach is client centered, strength-based, and trauma informed. I draw from various modalities including solution focus therapy, cognitive behavioral therapy, and dialectical behavioral therapy. I've had the privilege of working with individuals with a variety of diagnoses during my time in crisis intervention and as well as in outpatient settings. My goal for my practice is to create a safe and welcoming environment for all.
My name is Kalkidan Wilson, but I go by Kali. I am a dedicated and compassionate social worker with a master’s degree from Eastern Washington University. My therapeutic approach is client centered, strength-based, and trauma informed. I draw from various modalities including solution focus therapy, cognitive behavioral therapy, and dialectical behavioral therapy. I've had the privilege of working with individuals with a variety of diagnoses during my time in crisis intervention and as well as in outpatient settings. My goal for my practice is to create a safe and welcoming environment for all.
![Photo of Rachel Allison, LMHCA, Counselor](https://photos.psychologytoday.com/719269d7-e80c-45b7-861f-b1ec7320b4a8/1/320x400.png)
Rachel earned her masters degree from Grand Canyon University in Clinical Mental Health Counseling. Through the combination of her life experience and continuous education Rachel seeks to provide support and empowerment to her clients to improve their mental and physical health. She is passionate about helping her clients develop a positive sense of self-worth and purpose within a safe and accepting therapeutic environment. Rachel integrates therapeutic techniques from multiple theories including Cognitive behavioral therapy, Dialectical behavioral therapy, Emotionally focused therapy, Existential therapy and Interpersonal therapy.
Rachel earned her masters degree from Grand Canyon University in Clinical Mental Health Counseling. Through the combination of her life experience and continuous education Rachel seeks to provide support and empowerment to her clients to improve their mental and physical health. She is passionate about helping her clients develop a positive sense of self-worth and purpose within a safe and accepting therapeutic environment. Rachel integrates therapeutic techniques from multiple theories including Cognitive behavioral therapy, Dialectical behavioral therapy, Emotionally focused therapy, Existential therapy and Interpersonal therapy.
![Photo of Bahtyah Benyahmeen - Illuminating Wellness Therapeutic Services, MSW, RCSWI, LSWAIC, Clinical Social Work/Therapist](https://photos.psychologytoday.com/a7f6fc14-827b-412a-905d-3f06e5380bda/2/320x400.jpeg)
Illuminating Wellness Therapeutic Services
Clinical Social Work/Therapist, MSW, RCSWI, LSWAIC
Verified Verified
Spokane, WA 99201 (Online Only)
I want to help persons that are ready to do the work to heal from their history of hurt and pain.
I want to help persons that are ready to do the work to heal from their history of hurt and pain.
![Photo of Garret Holley, MA, LMHC, NCC, Counselor](https://photos.psychologytoday.com/f367f45b-72b9-41e0-812a-185d19a95789/2/320x400.jpeg)
When you become aware of yourself feeling anxious, depressed, or alone - you may wonder to yourself, how can I change or is change even possible for me? I believe that change happens within the context of being in connection with others; a felt sense of safety being the key component to be your most authentic self. I see clients who are wanting to grow in curiosity of their story, expand their awareness of themselves in and out of relationships, explore learning how to sit with unprocessed emotions, and build skills to be present with self and others.
When you become aware of yourself feeling anxious, depressed, or alone - you may wonder to yourself, how can I change or is change even possible for me? I believe that change happens within the context of being in connection with others; a felt sense of safety being the key component to be your most authentic self. I see clients who are wanting to grow in curiosity of their story, expand their awareness of themselves in and out of relationships, explore learning how to sit with unprocessed emotions, and build skills to be present with self and others.
![Photo of Rebecca McManus, MA, LMHC, Counselor](https://photos.psychologytoday.com/451fafdf-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
Rebecca McManus
Counselor, MA, LMHC
Verified Verified
1 Endorsed
Spokane, WA 99205
Waitlist for new clients
If you suffer from anxiety, depression, dissatisfying relationships, or a history of trauma, you are not alone. Whether you want to learn more about yourself, set goals, learn coping skills or just want someone to hold space for your emotions and thoughts, I'm here to help. I believe the therapeutic relationship is a major component to success. Our time together will be a safe place, grounded in empathy and non-judgment, where we can discuss your life's meaning, emotional well-being, relationships, and anything that's on your mind.
If you suffer from anxiety, depression, dissatisfying relationships, or a history of trauma, you are not alone. Whether you want to learn more about yourself, set goals, learn coping skills or just want someone to hold space for your emotions and thoughts, I'm here to help. I believe the therapeutic relationship is a major component to success. Our time together will be a safe place, grounded in empathy and non-judgment, where we can discuss your life's meaning, emotional well-being, relationships, and anything that's on your mind.
![Photo of Rachel Coleman, LICSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/63c6f95c-9150-471d-a604-9d5a75339222/2/320x400.jpeg)
These days life's challenges can feel overwhelming. Recognizing that we need support can feel daunting. Therapy offers a safe and compassionate environment for you to explore your strengths, learn tools for healing, develop resilience, and gain insight and clarity for moving forward in your life and your realtionships. I practice a strengths-based approach where clients are empowered to build upon their strengths, learn new skills, and achieve their best self.
These days life's challenges can feel overwhelming. Recognizing that we need support can feel daunting. Therapy offers a safe and compassionate environment for you to explore your strengths, learn tools for healing, develop resilience, and gain insight and clarity for moving forward in your life and your realtionships. I practice a strengths-based approach where clients are empowered to build upon their strengths, learn new skills, and achieve their best self.
Dr. Erma B Henry
Counselor, PhD, LMHCA, SUDPT, CFMS
Verified Verified
Spokane, WA 99203 (Online Only)
I am accepting a sliding scale fee for no insurance, no insurance means insurances not on my list, or out-of-network insurances typically will be at a lessor rate, just let me know what you can afford to pay.
I am accepting a sliding scale fee for no insurance, no insurance means insurances not on my list, or out-of-network insurances typically will be at a lessor rate, just let me know what you can afford to pay.
![Photo of Rachel Marrazzo, MA, CMHS, Counselor](https://photos.psychologytoday.com/3cb919b8-46cd-11ea-a6ad-06142c356176/8/320x400.jpeg)
Whether you are a parent dealing with child who is acting out or an individual suffering from depression or anxiety I believe I can partner with you to find answers. I work closely with with children, adolescents and families to help them figure out how to lead happy healthier lives. Life is hard and sometimes you just need someone there to come along side you and help you get back on your feet. I believe in a person centered approach to counseling that is focused and driven by the individual needs of each client.
Whether you are a parent dealing with child who is acting out or an individual suffering from depression or anxiety I believe I can partner with you to find answers. I work closely with with children, adolescents and families to help them figure out how to lead happy healthier lives. Life is hard and sometimes you just need someone there to come along side you and help you get back on your feet. I believe in a person centered approach to counseling that is focused and driven by the individual needs of each client.
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I believe that the power of a therapeutic relationship can be a catalyst for change. In our sessions, you can expect a collaborative, supportive, and nonjudgmental environment where you can freely explore your thoughts and emotions. You are the expert of your life experiences, and counseling can act as a resource towards achieving your individualized goals.
I believe that the power of a therapeutic relationship can be a catalyst for change. In our sessions, you can expect a collaborative, supportive, and nonjudgmental environment where you can freely explore your thoughts and emotions. You are the expert of your life experiences, and counseling can act as a resource towards achieving your individualized goals.
![Photo of Benjamin Rucker, MA, LMHC, NCC, Counselor](https://photos.psychologytoday.com/23efe11e-861a-44ae-87eb-04fe78be4f60/1/320x400.jpeg)
Benjamin Rucker
Counselor, MA, LMHC, NCC
Verified Verified
3 Endorsed
Spokane, WA 99207 (Online Only)
Are you looking to feel heard and understood? With acceptance and care, you are supported here. I have experience working with adults, teens, tweens, and children who were overcoming anxiety, ADHD, OCD, depression, trauma, addiction, post-concussive syndrome (TBI), career struggles, and disruptive life events (divorce or loss). Since graduating high school in 1995, I have been actively engaged in my own practice of emotional release and movement therapy to overcome my own childhood traumas.
Are you looking to feel heard and understood? With acceptance and care, you are supported here. I have experience working with adults, teens, tweens, and children who were overcoming anxiety, ADHD, OCD, depression, trauma, addiction, post-concussive syndrome (TBI), career struggles, and disruptive life events (divorce or loss). Since graduating high school in 1995, I have been actively engaged in my own practice of emotional release and movement therapy to overcome my own childhood traumas.
![Photo of Amanda Presho, MSW, LICSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/38525d9a-a40d-4f13-a017-29d78806e227/1/320x400.jpeg)
Amanda Presho
Clinical Social Work/Therapist, MSW, LICSW
Verified Verified
2 Endorsed
Spokane, WA 99208 (Online Only)
Welcome! I am a Licensed Independent Clinical Social Worker (LICSW). I want to be able to help support you through life's journey. I fully understand how overwhelming feelings of depression, anxiety or trauma can be. Plainly put, sometimes life can be challenging and we may need help figuring out what to do next or help with processing some big emotions. I'm here to help! We will work together to identify your individual goals and strengths to equip you with the tools you will need to accomplish those goals. No matter what the challenge is, I am confident we can work through it together!
Welcome! I am a Licensed Independent Clinical Social Worker (LICSW). I want to be able to help support you through life's journey. I fully understand how overwhelming feelings of depression, anxiety or trauma can be. Plainly put, sometimes life can be challenging and we may need help figuring out what to do next or help with processing some big emotions. I'm here to help! We will work together to identify your individual goals and strengths to equip you with the tools you will need to accomplish those goals. No matter what the challenge is, I am confident we can work through it together!
![Photo of Whitney A McDonald, MSW, LCSWA, LSWAIC, Clinical Social Work/Therapist](https://photos.psychologytoday.com/bf747ba5-1eda-4869-9007-86684888a49e/2/320x400.jpeg)
Whitney A McDonald
Clinical Social Work/Therapist, MSW, LCSWA, LSWAIC
Verified Verified
Spokane, WA 99201
Welcome to my practice! I'm Whitney, a Licensed Clinical Social Worker dedicated to supporting individuals on their journey towards mental and emotional well-being. With experience in the field, I bring a compassionate and non-judgmental approach to therapy. My therapeutic style is rooted in evidence-based practices, tailored to each client's unique needs and goals. Together, we'll uncover insights, develop coping strategies, and foster resilience, empowering you to lead a more fulfilling and balanced life. It takes courage to seek support, and I commend you for taking this important step towards your well-being.
Welcome to my practice! I'm Whitney, a Licensed Clinical Social Worker dedicated to supporting individuals on their journey towards mental and emotional well-being. With experience in the field, I bring a compassionate and non-judgmental approach to therapy. My therapeutic style is rooted in evidence-based practices, tailored to each client's unique needs and goals. Together, we'll uncover insights, develop coping strategies, and foster resilience, empowering you to lead a more fulfilling and balanced life. It takes courage to seek support, and I commend you for taking this important step towards your well-being.
![Photo of Harland C. Wable - Straight To The Point Counseling Services, MS, SUDPC, Drug & Alcohol Counselor](https://photos.psychologytoday.com/1540bf4a-3b10-4769-ba07-b4fe33f9d73e/2/320x400.jpeg)
Straight To The Point Counseling Services
Drug & Alcohol Counselor, MS, SUDPC
Verified Verified
1 Endorsed
Spokane, WA 99205
Addiction, be it Alcohol or Drugs, It is my opinion that all addictions are treatable, and all Recovery goals can be achieved when working together. I do not have all the answers, but working together we can develop a plan that may help you succeed in your recovery program. One just has to have the desire to want to change their lives, to be honest with themselves, to make a commitment to themselves, and be willing to do the work. Afterall, it's an investment in yourself. I invest a lot of time and effort into what I do because I truly love what I do. Afterall, it's about the person sitting across from me.
Addiction, be it Alcohol or Drugs, It is my opinion that all addictions are treatable, and all Recovery goals can be achieved when working together. I do not have all the answers, but working together we can develop a plan that may help you succeed in your recovery program. One just has to have the desire to want to change their lives, to be honest with themselves, to make a commitment to themselves, and be willing to do the work. Afterall, it's an investment in yourself. I invest a lot of time and effort into what I do because I truly love what I do. Afterall, it's about the person sitting across from me.
![Photo of Taylor Kennedy, MSW, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/4a16f839-ce99-43b5-9572-e9fb628cda5e/1/320x400.jpeg)
It can be so difficult to open up to new people and build the trust needed for therapy. My focus is on creating a calming, safe environment that will support you in developing new skills and meeting your goals. In my experience, a healthy, working relationship has been key to creating an opportunity for my clients to improve their mental health. I specialize in providing therapy to children, but also have experience working with adolescents and young adults.
It can be so difficult to open up to new people and build the trust needed for therapy. My focus is on creating a calming, safe environment that will support you in developing new skills and meeting your goals. In my experience, a healthy, working relationship has been key to creating an opportunity for my clients to improve their mental health. I specialize in providing therapy to children, but also have experience working with adolescents and young adults.
![Photo of Maryann Delaney, MSW, LICSW-A, Clinical Social Work/Therapist](https://photos.psychologytoday.com/f1accb9f-dd74-46b9-a297-b2dc4f82aeda/1/320x400.jpeg)
Maryann Delaney
Clinical Social Work/Therapist, MSW, LICSW-A
Verified Verified
1 Endorsed
Spokane, WA 99201
MaryAnn Delaney, a Licensed Independent Clinical Social Worker Associate, holds a Master's in Social Work from Eastern Washington University. Her training includes EMDR, Attachment Trauma Focused Therapy, Cognitive Behavioral Therapy, and Motivational Interviewing. MaryAnn is a certified Positive Parenting Program educator and Circle of Security Parent Educator, with comprehensive training in Circle of Security Core Sensitivities. Additionally, she brings five years of practical experience from a Montessori school, where she worked with children addressing learning and behavioral challenges.
MaryAnn Delaney, a Licensed Independent Clinical Social Worker Associate, holds a Master's in Social Work from Eastern Washington University. Her training includes EMDR, Attachment Trauma Focused Therapy, Cognitive Behavioral Therapy, and Motivational Interviewing. MaryAnn is a certified Positive Parenting Program educator and Circle of Security Parent Educator, with comprehensive training in Circle of Security Core Sensitivities. Additionally, she brings five years of practical experience from a Montessori school, where she worked with children addressing learning and behavioral challenges.
![Photo of Victoria Smith, LICSW, MHP, Clinical Social Work/Therapist](https://photos.psychologytoday.com/0d497a76-ff28-4d16-975c-a5a8fb6bdeef/2/320x400.jpeg)
Victoria Smith
Clinical Social Work/Therapist, LICSW, MHP
Verified Verified
Spokane, WA 99212 (Online Only)
Welcome! I specialize in working with people who are struggling with past trauma, anxiety, depression, parenting challenges, and managing stress and life changes. I believe in tackling problems using a collaborative approach, meeting people where they are in their lives, and working alongside them to help them learn, heal, and grow in order to achieve their goals.
Welcome! I specialize in working with people who are struggling with past trauma, anxiety, depression, parenting challenges, and managing stress and life changes. I believe in tackling problems using a collaborative approach, meeting people where they are in their lives, and working alongside them to help them learn, heal, and grow in order to achieve their goals.
![Photo of Bill Frye, MA, LMFT, Marriage & Family Therapist](https://photos.psychologytoday.com/54a4dee1-4eca-41cc-a546-0a06cbfa3cc9/5/320x400.jpeg)
Are you frustrated and feeling hopeless in your relationships? Do you argue with your partner without solving or even understanding what the problem really is? I specialize in working with couples who are struggling to connect. If you are desperate for communication and building trust, counseling can make a big difference. Whether you are looking for an individual, couples, or a family therapist I can be helpful as you discover new answers to the frustrations that have become exhausting. Let me help you focus your energy on actually solving problems, being understood, and feeling peace in your life.
Are you frustrated and feeling hopeless in your relationships? Do you argue with your partner without solving or even understanding what the problem really is? I specialize in working with couples who are struggling to connect. If you are desperate for communication and building trust, counseling can make a big difference. Whether you are looking for an individual, couples, or a family therapist I can be helpful as you discover new answers to the frustrations that have become exhausting. Let me help you focus your energy on actually solving problems, being understood, and feeling peace in your life.
See more therapy options for Spokane
How does your Therapist compare?
Number of Therapists in Spokane, WA
1,000+
Average cost per session
$140
Therapists in Spokane, WA who prioritize treating:
92% | Anxiety |
86% | Depression |
76% | Self Esteem |
73% | Relationship Issues |
73% | Trauma and PTSD |
72% | Stress |
70% | Coping Skills |
Average years in practice
7 Years
Top 3 insurances accepted
73% | Aetna |
72% | Premera |
60% | Regence |
How Therapists in Spokane, WA see their clients
52% | In Person and Online | |
48% | Online Only |
Gender breakdown
80% | Female | |
19% | Male | |
1% | Non-Binary |
FAQs - About Therapy and Counseling
How can I find a therapist in Spokane?
Search for nearby therapists or counselors by inputting your city, town, or suburb; or zip code; or a provider’s name into the search bar. From there, you can filter providers by the issues they treat, cost, insurance, gender, and other factors to find providers who are well-suited to your needs. To navigate between locations within the same country, enter a new city or zip code into the search bar.
Learn more about how to find a therapist
Learn more about how to find a therapist
Is everyone in the Psychology Today Therapy Directory a licensed therapist?
The Psychology Today directory lists providers who offer legitimate mental health services to the public, including psychologists, psychiatrists, social workers, and counselors.
Many have been licensed by the country or state where they practice; providers whose license or primary credential has been verified by Psychology Today are signified by a “Verified” symbol. Some clinicians or organizations provide services for which their state or country does not offer licenses, such as pastoral counseling. They may be selectively included without the “Verified” seal.
Many have been licensed by the country or state where they practice; providers whose license or primary credential has been verified by Psychology Today are signified by a “Verified” symbol. Some clinicians or organizations provide services for which their state or country does not offer licenses, such as pastoral counseling. They may be selectively included without the “Verified” seal.
What’s the difference between a psychologist, a therapist, and a counselor?
Therapists, psychologists, and counselors are all licensed mental health professionals. In the US, psychologists have earned a doctoral degree. The terms “therapist” and “counselor” are used somewhat interchangeably, but generally therapists offer longer-term, mental health care, while counselors offer shorter-term care that may focus on one domain, such as marriage, career, or academic challenges.
Clients should consider factors such as insurance coverage and their primary reason(s) for seeking therapy to determine the type of professional best suited to their needs. Someone struggling with mental health challenges such as depression or anxiety, for example, may wish to seek out a clinical psychologist or therapist, while someone navigating career obstacles or marital upheaval may benefit from seeing a counselor who can offer short-term, targeted support.
Clients should consider factors such as insurance coverage and their primary reason(s) for seeking therapy to determine the type of professional best suited to their needs. Someone struggling with mental health challenges such as depression or anxiety, for example, may wish to seek out a clinical psychologist or therapist, while someone navigating career obstacles or marital upheaval may benefit from seeing a counselor who can offer short-term, targeted support.
What type of therapy is right for me?
The type of therapy best suited to a particular individual depends on several factors, including their primary reason for seeking therapy, their preferred timeline (some therapy types last for a set number of sessions, while others are open-ended), and their personality and preferences—some may prefer a more structured approach. For many individuals, multiple types of therapy could provide a good fit.
How much does therapy cost?
The cost of therapy depends on a number of variables, including location and the therapist’s experience and training. On average, a therapy session in the United States could cost between $100 and $200 or more. If you have insurance, the expense of mental health care is typically lower, but it varies based on your insurance plan details and whether you choose an in-network or out-of-network mental healthcare provider.
What are more affordable or low cost therapy solutions?
Many therapists offer sliding scale payments, usually on a limited number of slots, which consists in an agreement between the therapist and a client to pay a reduced rate. Therapists who provide such arrangements often consider the client's income or ability to pay, but the extent of the discount is ultimately at the therapist's discretion. Furthermore, while group therapy may have different goals and benefits compared to individual therapy, it can be a more affordable solution to address certain types of issues.
Is online therapy cheaper than in-person therapy?
Many therapists charge the same amount for online therapy as they do for in-person therapy—though clients may still find this cost-effective if it cuts down on their transportation costs. Health insurance plans often offer equivalent coverage for online and in-person therapy; indeed, in many places, they are legally required to do so. Text-based or on-demand therapy apps may be cheaper than traditional one-on-one psychotherapy; however, the practice may be less effective and is not likely to be covered by insurance.
Is online therapy a good option?
Therapy conducted online can be just as effective as in-person therapy, as long as there is a strong alliance between the client and the therapist. To find a therapist who provides telehealth services to clients in your area, click “Online Therapy” on the directory homepage and search by your city or town or your zip code.
Are therapy sessions confidential?
Confidentiality is a crucial part of the therapeutic relationship. Therapists in the United States are bound by the regulations set out by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which aims to protect sensitive health information. With very few exceptions, a therapist will only discuss their client with others when the client has given their written permission. The instances in which a therapist would be required to disclose personal information are: if a client poses a danger to themselves or others, if the therapist suspects the abuse of a child or an elderly or otherwise dependent adult, or if they are legally forced to by court order. These exceptions to the confidentiality agreement are usually discussed with a client before their first session.