Therapists in Dinuba, CA
![Photo of Dino Koutsolioutsos, LMFT, Marriage & Family Therapist](https://photos.psychologytoday.com/7158b64a-a30b-45a8-b312-d8966b284e8c/2/320x400.jpeg)
I am Dino Koutsolioutsos and I am a licensed Marriage and Family Therapist since the mid-1980s. I consider psychotherapy a good, but not a necessary, tool to address and explore life issues. I approach therapy as a friend and as another human being in the struggle and joy that is called life. My approach to therapy is instinctive, conversational, and relational. I believe my duty as a therapist is first, to listen, to try to understand, to empathize, and relate to the issues of another human being and then to respond and assist the other person in finding solutions to life's challenges and grow.
I am Dino Koutsolioutsos and I am a licensed Marriage and Family Therapist since the mid-1980s. I consider psychotherapy a good, but not a necessary, tool to address and explore life issues. I approach therapy as a friend and as another human being in the struggle and joy that is called life. My approach to therapy is instinctive, conversational, and relational. I believe my duty as a therapist is first, to listen, to try to understand, to empathize, and relate to the issues of another human being and then to respond and assist the other person in finding solutions to life's challenges and grow.
![Photo of Mayra Calatayud-Garcia, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/01b8e22e-3ebe-4c51-8f7b-00feb69540ad/1/320x400.jpeg)
Hello, my name is Mayra Calatayud-Garcia. I am a Licensed Clinical Social Worker (LCSW) based in Los Angeles, California. I work with adults from ages 18 to 65+ living in the state of California. I specialize in anxiety, stress, depression, grief, and trauma, using Internal Family Systems (IFS) and Somatic therapy to guide my clients in their mental and wellness journey. My approach to therapy varies depending on the needs, challenges, and goals of each client. Each client is unique and has an important story to tell. I start where the client is and strive to cultivate a safe space based on compassion and acceptance.
Hello, my name is Mayra Calatayud-Garcia. I am a Licensed Clinical Social Worker (LCSW) based in Los Angeles, California. I work with adults from ages 18 to 65+ living in the state of California. I specialize in anxiety, stress, depression, grief, and trauma, using Internal Family Systems (IFS) and Somatic therapy to guide my clients in their mental and wellness journey. My approach to therapy varies depending on the needs, challenges, and goals of each client. Each client is unique and has an important story to tell. I start where the client is and strive to cultivate a safe space based on compassion and acceptance.
![Photo of Amber Trueblood, LMFT, Marriage & Family Therapist](https://photos.psychologytoday.com/dc08cdc3-30e0-4c41-a1b0-06d8fbf24d7b/2/320x400.jpeg)
Hello, I'm Amber Trueblood LMFT, MBA. My expertise is providing solution-based therapy to clients currently dealing with relationship challenges, parenting issues, anxiety, overwhelm, or emotional burnout. When I'm not working with clients, I'm writing books and articles, taking dance classes, reading, traveling, and raising my four sons. My core areas of expertise and experience in the last 12 years are relationships, parenting, educational concerns with children, motherhood, out schooling/homeschooling, parenting profoundly gifted children, and mom burnout.
Hello, I'm Amber Trueblood LMFT, MBA. My expertise is providing solution-based therapy to clients currently dealing with relationship challenges, parenting issues, anxiety, overwhelm, or emotional burnout. When I'm not working with clients, I'm writing books and articles, taking dance classes, reading, traveling, and raising my four sons. My core areas of expertise and experience in the last 12 years are relationships, parenting, educational concerns with children, motherhood, out schooling/homeschooling, parenting profoundly gifted children, and mom burnout.
![Photo of Lynette Statham, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/ae16ff00-cbea-421f-a62e-80ed918b24c2/1/320x400.png)
When a person decides to talk about their thoughts and feelings, or their situation, I believe they deserve to be listened to. What a person has to say and their views are critical to me. I also think my clients hold many solutions within themselves. My therapeutic style is caring, open, and honest toward this end. You can expect a high level of interaction, energy, and a touch of humor. I approach therapy with an eclectic assortment of approaches and tools to individualize our work together to meet your needs best. I will enjoy working with you toward the goals we set together.
When a person decides to talk about their thoughts and feelings, or their situation, I believe they deserve to be listened to. What a person has to say and their views are critical to me. I also think my clients hold many solutions within themselves. My therapeutic style is caring, open, and honest toward this end. You can expect a high level of interaction, energy, and a touch of humor. I approach therapy with an eclectic assortment of approaches and tools to individualize our work together to meet your needs best. I will enjoy working with you toward the goals we set together.
![Photo of Amy Gillespie, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/d1094e5c-daa7-4fa9-a459-b86b03db1d20/1/320x400.jpeg)
My name is Amy Gillespie and I'm a Licensed Clinical Social Worker (LCSW) working with clients throughout California via telehealth. I work with adolescents and adults and have over 10 years of clinical experience, specializing in trauma, depression, anxiety, and work-related burnout. I am trained in EMDR and IFS and utilize techniques from other treatment modalities that best connect with my client's needs.
My name is Amy Gillespie and I'm a Licensed Clinical Social Worker (LCSW) working with clients throughout California via telehealth. I work with adolescents and adults and have over 10 years of clinical experience, specializing in trauma, depression, anxiety, and work-related burnout. I am trained in EMDR and IFS and utilize techniques from other treatment modalities that best connect with my client's needs.
![Photo of Sabrina Lucas, LMFT, Marriage & Family Therapist](https://photos.psychologytoday.com/8b462ca3-7ac6-4310-80ad-57247b1fd246/2/320x400.jpeg)
I am a licensed Marriage and Family Therapist (MFT) in California with 5 years of professional work experience. I have experience in helping clients with stress and anxiety, relationship issues, anger management, and depression. I work with my clients to create an open and safe environment where thoughts and feelings can be shared without fear of judgment. Taking the first step to sign up for therapy can take courage and I am proud of you for getting started!
I am a licensed Marriage and Family Therapist (MFT) in California with 5 years of professional work experience. I have experience in helping clients with stress and anxiety, relationship issues, anger management, and depression. I work with my clients to create an open and safe environment where thoughts and feelings can be shared without fear of judgment. Taking the first step to sign up for therapy can take courage and I am proud of you for getting started!
![Photo of Kellisha Priester, LMFT, Marriage & Family Therapist](https://photos.psychologytoday.com/f47eda6a-51b7-4d90-9ca1-4531e8d46cd4/1/320x400.jpeg)
Hi, I'm Kay Priester, a Licensed Marriage and Family Therapist and Professional Clinical Counselor. With 20 years of experience in the Behavioral Health field, it has been an honor and privilege to support my clients through life's challenges and work relentlessly to reach their goals.
Hi, I'm Kay Priester, a Licensed Marriage and Family Therapist and Professional Clinical Counselor. With 20 years of experience in the Behavioral Health field, it has been an honor and privilege to support my clients through life's challenges and work relentlessly to reach their goals.
![Photo of Mary Stein, LMFT, Marriage & Family Therapist](https://photos.psychologytoday.com/4993d851-3c00-4569-94dc-7f650ade97ab/1/320x400.jpeg)
Thank you for your interest in therapy. I am Mary Stein, a licensed Marriage and Family Therapist (LMFT). For over twenty years, I have enjoyed working with individuals, couples, and families. In particular, my work includes helping clients who are experiencing symptoms of anxiety, depression, trauma, abuse, grief, and life challenges. My counseling style is warm, accepting, and interactive. I believe in being respectful, kind and providing a safe environment and positive feedback for each client.
Thank you for your interest in therapy. I am Mary Stein, a licensed Marriage and Family Therapist (LMFT). For over twenty years, I have enjoyed working with individuals, couples, and families. In particular, my work includes helping clients who are experiencing symptoms of anxiety, depression, trauma, abuse, grief, and life challenges. My counseling style is warm, accepting, and interactive. I believe in being respectful, kind and providing a safe environment and positive feedback for each client.
The Allen H. Middleton Veterans Counseling Clinic
Psychologist, PhD
Verified Verified
Dinuba, CA 93618
If you suffer from debilitating panic attacks, persistent worry, fears or phobias, or stress from trauma experiences, help is available. We work to help patients better understand and manage the physical and psychological effects of anxiety disorders. Through personalized treatment, we can examine the causes of your anxiety, analyze the emotions associated with it, and reveal how you can change the resulting negative thoughts and behaviors. Our goal is to help you experience freedom from the debilitating effects of anxiety disorders and improve your quality of life.
If you suffer from debilitating panic attacks, persistent worry, fears or phobias, or stress from trauma experiences, help is available. We work to help patients better understand and manage the physical and psychological effects of anxiety disorders. Through personalized treatment, we can examine the causes of your anxiety, analyze the emotions associated with it, and reveal how you can change the resulting negative thoughts and behaviors. Our goal is to help you experience freedom from the debilitating effects of anxiety disorders and improve your quality of life.
![Photo of Horacio Renteria, MDiv, LMFT, Marriage & Family Therapist](https://photos.psychologytoday.com/5cc55797-e2d4-48e1-942a-6e54dc9bbb81/1/320x400.jpeg)
Sometimes, you just need some support. Life is full of challenges, but you don’t have to face them all alone. That’s what I am here to do: help you overcome stress, depression, anxiety, and any other issues that may be inhibiting your mental health, relationships, and success. I have been a therapist for almost 10 years now, and I have worked with a large range of clients: from individuals of all ages, to couples, to families.
Sometimes, you just need some support. Life is full of challenges, but you don’t have to face them all alone. That’s what I am here to do: help you overcome stress, depression, anxiety, and any other issues that may be inhibiting your mental health, relationships, and success. I have been a therapist for almost 10 years now, and I have worked with a large range of clients: from individuals of all ages, to couples, to families.
![Photo of Evelyn Serna-Balderas, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/1a2c3c64-5b37-4ca2-a977-1a8435f97046/1/320x400.png)
Hi I’m Evelyn Serna-Balderas. I am a licensed clinical social Worker who appreciates and is motivated in working with individuals to navigate through challenges and experience growth in their journey. I have had the opportunity to work with a wide variety of clients ranging from children to older adults. I often engage clients who are dealing with anxiety, depression, difficulty in life transitions, bipolar diagnosis, BPD, and dual diagnosis.
Hi I’m Evelyn Serna-Balderas. I am a licensed clinical social Worker who appreciates and is motivated in working with individuals to navigate through challenges and experience growth in their journey. I have had the opportunity to work with a wide variety of clients ranging from children to older adults. I often engage clients who are dealing with anxiety, depression, difficulty in life transitions, bipolar diagnosis, BPD, and dual diagnosis.
![Photo of Stacy Froehlich, LMFT, Marriage & Family Therapist](https://photos.psychologytoday.com/8b87fb07-cb45-4997-ba2d-d605827b0b5f/2/320x400.jpeg)
My name is Stacy Froehlich licensed Marriage, Family Therapist (License No. 46901. My therapeutic approach emphasizes forward-thinking, focusing on empowering clients with tools and strategies to navigate depression, anxiety, personal and family issues, and adolescent challenges. I integrate cognitive-behavioral techniques with mindfulness and positive psychology to foster resilience and promote lasting change in my clients' lives.
My name is Stacy Froehlich licensed Marriage, Family Therapist (License No. 46901. My therapeutic approach emphasizes forward-thinking, focusing on empowering clients with tools and strategies to navigate depression, anxiety, personal and family issues, and adolescent challenges. I integrate cognitive-behavioral techniques with mindfulness and positive psychology to foster resilience and promote lasting change in my clients' lives.
![Photo of Tanya Frausto, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/08fc857c-d75a-453d-aa89-ac79871c5d78/2/320x400.jpeg)
Hello, my name is Tanya Frausto. I proudly identify as a bilingual, first-generation Latina college graduate, daughter of immigrants, who comes from a low-income background. I earned a bachelor’s degree from the University of San Diego, a master’s degree in social work from San Diego State University, and am licensed in the state of California. I have 13 years in the helping profession serving clients in all stages of life from school-aged children to the elderly. For the past eight years, I have served veterans in a skilled nursing facility, supporting them through end-of-life issues, adjustment, depression, anxiety, and grief.
Hello, my name is Tanya Frausto. I proudly identify as a bilingual, first-generation Latina college graduate, daughter of immigrants, who comes from a low-income background. I earned a bachelor’s degree from the University of San Diego, a master’s degree in social work from San Diego State University, and am licensed in the state of California. I have 13 years in the helping profession serving clients in all stages of life from school-aged children to the elderly. For the past eight years, I have served veterans in a skilled nursing facility, supporting them through end-of-life issues, adjustment, depression, anxiety, and grief.
![Photo of Dimitri Gatsiounis, LMFT, Marriage & Family Therapist](https://photos.psychologytoday.com/aa09c8a9-548d-4b51-8346-df8940567e70/1/320x400.jpeg)
I’m a psychodynamic therapist. I specialize in anxiety, depression, addiction, relationships, and grief. I work with adults, adolescents and couples, guiding them toward living an examined life. From here they begin to connect with their true self, building self-esteem, resolving painful conflicts, improving their relationships and transforming their lives.
I’m a psychodynamic therapist. I specialize in anxiety, depression, addiction, relationships, and grief. I work with adults, adolescents and couples, guiding them toward living an examined life. From here they begin to connect with their true self, building self-esteem, resolving painful conflicts, improving their relationships and transforming their lives.
![Photo of JoAnn Scott, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/336c802b-0919-44c5-a062-63ae1fc25560/1/320x400.jpeg)
Hi, my name is JoAnn Scott. My mission as a therapist is to initially help people develop hope, then help them discover their best selves during our therapeutic journey. I do this using individualized therapeutic techniques that are best suited for the challenges and concerns that you have identified as most important. I am a Licensed Clinical Social Worker, master's Level Registered Addiction Specialist, Board Certified Diplomate in Clinical Social Work, and a Certified Clinical Trauma Professional.
Hi, my name is JoAnn Scott. My mission as a therapist is to initially help people develop hope, then help them discover their best selves during our therapeutic journey. I do this using individualized therapeutic techniques that are best suited for the challenges and concerns that you have identified as most important. I am a Licensed Clinical Social Worker, master's Level Registered Addiction Specialist, Board Certified Diplomate in Clinical Social Work, and a Certified Clinical Trauma Professional.
![Photo of Sarah Scott, LCP, Psychologist](https://photos.psychologytoday.com/a1016e0a-e707-4053-9c2c-3cc262285e5e/1/320x400.png)
My name is Dr. Scott, I have been practicing in the field for about 8 years providing individual therapy to clients. My experience has focused on brief interventions and helping clients through difficult transitions. I believe that therapy is about planting seeds and helping clients to build the toolset they need to help them grow. I am looking for clients who are looking for supportive therapies through difficult transitions or as a means of processing day-to-day stressors associated with familial roles, job stressors, and/or general life transitions as these are my specialties.
My name is Dr. Scott, I have been practicing in the field for about 8 years providing individual therapy to clients. My experience has focused on brief interventions and helping clients through difficult transitions. I believe that therapy is about planting seeds and helping clients to build the toolset they need to help them grow. I am looking for clients who are looking for supportive therapies through difficult transitions or as a means of processing day-to-day stressors associated with familial roles, job stressors, and/or general life transitions as these are my specialties.
![Photo of Melanie Crowell, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/3bd5b0eb-f64b-4c41-bb8d-dafb68d60098/1/320x400.jpeg)
With years of experience in Cognitive Behavioral Therapy, I can assist and support you in reaching your therapeutic goals. I’m passionate about meeting your mental health objectives through warm engagement, empathetic understanding, and demonstrating my ability to meet you wherever you are in life. I understand you feel the weight of the world on your shoulders. Let me help you with that!
With years of experience in Cognitive Behavioral Therapy, I can assist and support you in reaching your therapeutic goals. I’m passionate about meeting your mental health objectives through warm engagement, empathetic understanding, and demonstrating my ability to meet you wherever you are in life. I understand you feel the weight of the world on your shoulders. Let me help you with that!
![Photo of Satinder Gill, CP, Psychologist](https://photos.psychologytoday.com/d8f44476-482c-4a68-97a1-2c031a3e3ec4/1/320x400.png)
Dr. Gill is a CA-based, Board Certified Licensed Clinical Psychologist with over 15 years of experience providing psychotherapy, coaching, teaching, and consultation services. Dr. Gill utilizes a holistic approach to helping clients manage their health and well-being by utilizing the biopsychosocial model to assess for and conceptualize disease in the mind-body of the individual. As experiences and functioning in daily life are influenced by an intersection of numerous factors including social systems and structures, Dr. Gill works to address the impacts of experiences with privilege and oppression on an individual's mental health.
Dr. Gill is a CA-based, Board Certified Licensed Clinical Psychologist with over 15 years of experience providing psychotherapy, coaching, teaching, and consultation services. Dr. Gill utilizes a holistic approach to helping clients manage their health and well-being by utilizing the biopsychosocial model to assess for and conceptualize disease in the mind-body of the individual. As experiences and functioning in daily life are influenced by an intersection of numerous factors including social systems and structures, Dr. Gill works to address the impacts of experiences with privilege and oppression on an individual's mental health.
![Photo of Kacey Klein, LMFT, Marriage & Family Therapist](https://photos.psychologytoday.com/e2ae38f7-3a07-4ed4-ac80-f8c46873ad58/1/320x400.jpeg)
Life can be overwhelming for a number of reasons and it's natural to seek help to find clarity and stability. Therapy can help you work through a crisis and better understand your feelings amid struggle. The journey can be hard and very emotional, but it is worth the time and energy you put in. Whether you are in the midst of a crisis or want to understand better what makes you tick, therapy can help. I believe therapy is a team effort. We will work together to assess your unique needs and capacities. By intently listening to your personal stories and practicing self-reflection, we will build upon your strengths.
Life can be overwhelming for a number of reasons and it's natural to seek help to find clarity and stability. Therapy can help you work through a crisis and better understand your feelings amid struggle. The journey can be hard and very emotional, but it is worth the time and energy you put in. Whether you are in the midst of a crisis or want to understand better what makes you tick, therapy can help. I believe therapy is a team effort. We will work together to assess your unique needs and capacities. By intently listening to your personal stories and practicing self-reflection, we will build upon your strengths.
![Photo of Gladis Romero, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/d6a0eb32-0653-4f23-adc5-69405adfe41e/1/320x400.jpeg)
Hello! My name is Gladis Romero, and I am a Licensed Clinical Social Worker. I have a passion for accompanying my clients through their journey of redefining their life goals, unlearning patterns and beliefs that no longer serve them, and reaching new heights of self-awareness and self-love. I focus on clients struggling with self-esteem, breakups, anxiety, and dating. I have worked with the TAY population, clients with co-occurring diagnoses, and justice-involved individuals. In this particular setting, I aim to focus my therapy services on clients 18-25 years old.
Hello! My name is Gladis Romero, and I am a Licensed Clinical Social Worker. I have a passion for accompanying my clients through their journey of redefining their life goals, unlearning patterns and beliefs that no longer serve them, and reaching new heights of self-awareness and self-love. I focus on clients struggling with self-esteem, breakups, anxiety, and dating. I have worked with the TAY population, clients with co-occurring diagnoses, and justice-involved individuals. In this particular setting, I aim to focus my therapy services on clients 18-25 years old.
See more therapy options for Dinuba
How does your Therapist compare?
Number of Therapists in Dinuba, CA
20+
Average cost per session
$162
Therapists in Dinuba, CA who prioritize treating:
96% | Anxiety |
85% | Depression |
81% | Coping Skills |
73% | Relationship Issues |
69% | Life Transitions |
65% | Grief |
65% | Self Esteem |
Average years in practice
17 Years
Top 3 insurances accepted
96% | Cigna and Evernorth |
96% | Managed Health Network (MHN) |
96% | UnitedHealthcare UHC | UBH |
How Therapists in Dinuba, CA see their clients
93% | In Person and Online | |
7% | Online Only |
Gender breakdown
88% | Female | |
12% | Male |
FAQs - About Therapy and Counseling
How can I find a therapist in Dinuba?
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.