Therapists in Carroll, IA

Photo of Thea Guest, LISW, Clinical Social Work/Therapist
Thea Guest
Clinical Social Work/Therapist, LISW
Verified Verified
Carroll, IA 51401
Waitlist for new clients
I received both Bachelor's degrees in Child Development and Family Relations, and a Masters Degree in Social Work and worked as a Substance Abuse Counselor for 3 years in Iowa, with both adults and adolescents. Prior to this, I worked with all age groups, treating a wide range of mental health issues, not limit to but including, depression, anxiety, relationship issues, trauma, attachment, and family matters with couples. I have a passion for providing families and individuals the help needed to find balance, and grow in their knowledge of health and peaceful living.
I received both Bachelor's degrees in Child Development and Family Relations, and a Masters Degree in Social Work and worked as a Substance Abuse Counselor for 3 years in Iowa, with both adults and adolescents. Prior to this, I worked with all age groups, treating a wide range of mental health issues, not limit to but including, depression, anxiety, relationship issues, trauma, attachment, and family matters with couples. I have a passion for providing families and individuals the help needed to find balance, and grow in their knowledge of health and peaceful living.
(712) 624-7874 View (712) 624-7874
Tina Zanders
Clinical Social Work/Therapist, MS, , LMSW
Verified Verified
Carroll, IA 51401
I currently work for Catholic Charities and have done so since 2007. I have been working with children, adolescents, couples, and families for nearly 30 yrs years who are experiencing acute or chronic mental health issues. Some of those issues include but are not limited to: grief/loss, life stressors/traumas, depression, anxiety, relationship problems, behavioral issues in children, and ADHD. When I ask my client's what they are hoping to gain from therapy, most will summarize that they simply want to feel better! So that is what we (you and me) will set out to accomplish.
I currently work for Catholic Charities and have done so since 2007. I have been working with children, adolescents, couples, and families for nearly 30 yrs years who are experiencing acute or chronic mental health issues. Some of those issues include but are not limited to: grief/loss, life stressors/traumas, depression, anxiety, relationship problems, behavioral issues in children, and ADHD. When I ask my client's what they are hoping to gain from therapy, most will summarize that they simply want to feel better! So that is what we (you and me) will set out to accomplish.
(712) 792-9597 View (712) 792-9597
Photo of Whitney Cue, tLMHC, CADC, Counselor
Whitney Cue
Counselor, tLMHC, CADC
Verified Verified
Carroll, IA 51401
Hey there! If you are reading this, I want to let you know that I am already proud of you for taking the first step in seeking help. My goal as a therapist is to work alongside you in achieving whatever challenges you are facing that is preventing you from living your best life. You can rest assured that working with me will be judgement-free.
Hey there! If you are reading this, I want to let you know that I am already proud of you for taking the first step in seeking help. My goal as a therapist is to work alongside you in achieving whatever challenges you are facing that is preventing you from living your best life. You can rest assured that working with me will be judgement-free.
(712) 409-7502 View (712) 409-7502
Photo of Anne Miller - Anne Miller - FL, SC, IA, IN, & ID, LISW, Clinical Social Work/Therapist
Anne Miller - FL, SC, IA, IN, & ID
Clinical Social Work/Therapist, LISW
Verified Verified
8 Endorsed
Carroll, IA 51401  (Online Only)
Do you often feel overwhelmed and burnt out, unable to say "no" to others? Do you constantly go out of your way for everyone else, hoping to receive the same in return? Maybe you're struggling to understand who you are or dealing with feelings of not being good enough. I help people like you navigate parenting, build self-confidence, challenge anxious thoughts, and establish healthy boundaries. It might seem impossible to make changes. Prioritizing yourself may even feel selfish, but you deserve the same love you give others.
Do you often feel overwhelmed and burnt out, unable to say "no" to others? Do you constantly go out of your way for everyone else, hoping to receive the same in return? Maybe you're struggling to understand who you are or dealing with feelings of not being good enough. I help people like you navigate parenting, build self-confidence, challenge anxious thoughts, and establish healthy boundaries. It might seem impossible to make changes. Prioritizing yourself may even feel selfish, but you deserve the same love you give others.
(712) 423-5676 View (712) 423-5676
Photo of Kay Lynn Haubrich, MSW, LISW, Clinical Social Work/Therapist
Kay Lynn Haubrich
Clinical Social Work/Therapist, MSW, LISW
Verified Verified
Carroll, IA 51401
We all face difficult situations in our lives that can leave us feeling alone and overwhelmed. My goal is to help you find your true potential to lead a full and productive life. Together we can work to better understand and resolve the challenges that you face. By applying complimentary therapy approaches and techniques, we will identify negative perceptions or behavior patterns that may be keeping you from experiencing a more fulfilling and meaningful life.
We all face difficult situations in our lives that can leave us feeling alone and overwhelmed. My goal is to help you find your true potential to lead a full and productive life. Together we can work to better understand and resolve the challenges that you face. By applying complimentary therapy approaches and techniques, we will identify negative perceptions or behavior patterns that may be keeping you from experiencing a more fulfilling and meaningful life.
(712) 790-1842 View (712) 790-1842
Photo of Alexandria Harmening - Vine Christian Counseling Services, LMSW, Clinical Social Work/Therapist
Vine Christian Counseling Services
Clinical Social Work/Therapist, LMSW
Verified Verified
Carroll, IA 51401
Searching for help is a courageous first step to change. You may be feeling anxious or depressed. Are you looking for support in changing addictive behaviors from a non-judgmental approach? Perhaps you have experienced traumatic events that have left you feeling "stuck." Or maybe you have relationship issues and aren't sure where to go from here. Whatever your needs, there IS hope.
Searching for help is a courageous first step to change. You may be feeling anxious or depressed. Are you looking for support in changing addictive behaviors from a non-judgmental approach? Perhaps you have experienced traumatic events that have left you feeling "stuck." Or maybe you have relationship issues and aren't sure where to go from here. Whatever your needs, there IS hope.
(515) 489-4922 View (515) 489-4922
Photo of Lois Potthoff, LMHC, MS, Counselor
Lois Potthoff
Counselor, LMHC, MS
Verified Verified
Carroll, IA 51401
I strive to help others heal and become empowered while rediscovering their true sense of self and reconnect with their life purpose. Relationship is the foundation to healing and I use a client centered and attuned approach while integrating an individualized treatment plan to meet your goals. My goal is to meet you or your child where they are and be your guide to healing. I have over 30 years of experience working in the field of mental illness and developmental disorders.
I strive to help others heal and become empowered while rediscovering their true sense of self and reconnect with their life purpose. Relationship is the foundation to healing and I use a client centered and attuned approach while integrating an individualized treatment plan to meet your goals. My goal is to meet you or your child where they are and be your guide to healing. I have over 30 years of experience working in the field of mental illness and developmental disorders.
(712) 350-9905 View (712) 350-9905
Photo of Michelle Loew, LMHC, Counselor
Michelle Loew
Counselor, LMHC
Verified Verified
Carroll, IA 51401
Embarking on the path to healing takes courage, and I commend you for taking the first step. If you're reading this, you're likely seeking a safe space to explore your thoughts, emotions, and experiences. I'm here to offer guidance, support, and empowerment as you embark on your journey. You may be feeling uncertain or hesitant, and that's completely understandable. I encourage you to embrace this opportunity for self-discovery and growth. I work with a diverse range of individuals, including those experiencing anxiety, depression, trauma, relationship issues, difficult life transitions, grief, and loss.
Embarking on the path to healing takes courage, and I commend you for taking the first step. If you're reading this, you're likely seeking a safe space to explore your thoughts, emotions, and experiences. I'm here to offer guidance, support, and empowerment as you embark on your journey. You may be feeling uncertain or hesitant, and that's completely understandable. I encourage you to embrace this opportunity for self-discovery and growth. I work with a diverse range of individuals, including those experiencing anxiety, depression, trauma, relationship issues, difficult life transitions, grief, and loss.
(712) 214-5447 View (712) 214-5447
Photo of Britney Randolph, LISW, Clinical Social Work/Therapist
Britney Randolph
Clinical Social Work/Therapist, LISW
Verified Verified
Carroll, IA 51401
I began working as a helping professional in 2006 as a certified nurse’s aide. I always knew I wanted to help others in some capacity. When I started taking college classes, my path to becoming a therapist was not yet clear; until I found social work. After receiving my bachelor’s degree in social work from Buena Vista University in 2011, I did work ranging from helping families involved with Iowa DHHS to working as a counselor for patients in inpatient substance abuse treatment. While working as a counselor, I realized that I had a passion for meeting people where they are in their journey and assisting to meet their goals.
I began working as a helping professional in 2006 as a certified nurse’s aide. I always knew I wanted to help others in some capacity. When I started taking college classes, my path to becoming a therapist was not yet clear; until I found social work. After receiving my bachelor’s degree in social work from Buena Vista University in 2011, I did work ranging from helping families involved with Iowa DHHS to working as a counselor for patients in inpatient substance abuse treatment. While working as a counselor, I realized that I had a passion for meeting people where they are in their journey and assisting to meet their goals.
(712) 217-2351 View (712) 217-2351

Online Therapists

Photo of Shellie Matt - Shellie Matt Psychotherapy, EdS, MA, Counselor
Shellie Matt Psychotherapy
Counselor, EdS, MA
Verified Verified
1 Endorsed
West Des Moines, IA 50266
Waitlist for new clients
As a psychotherapist with 30 years experience I provide depth therapy for people suffering from personal or collective trauma, depression, stress, anxiety, relationship, identity concerns, grief and loss, religious injury, emptiness, mood regulation, creative blocks, and career and life transition struggles. Jungian psychotherapy not only addresses one's immediate personal life problems, but also explores the underlying psychological and spiritual issues that might be contributing to your suffering. It can provide an opportunity to become more conscious of unhealthy and maladaptive patterns and increase overall well-being.
As a psychotherapist with 30 years experience I provide depth therapy for people suffering from personal or collective trauma, depression, stress, anxiety, relationship, identity concerns, grief and loss, religious injury, emptiness, mood regulation, creative blocks, and career and life transition struggles. Jungian psychotherapy not only addresses one's immediate personal life problems, but also explores the underlying psychological and spiritual issues that might be contributing to your suffering. It can provide an opportunity to become more conscious of unhealthy and maladaptive patterns and increase overall well-being.
(515) 996-4721 View (515) 996-4721
Photo of Janzie Mason, LMSW, CADC, PLMHP, PCSMW, Clinical Social Work/Therapist
Janzie Mason
Clinical Social Work/Therapist, LMSW, CADC, PLMHP, PCSMW
Verified Verified
Council Bluffs, IA 51503
Currently accepting new clients from Iowa and Nebraska. Immediate openings available. I am a Clinical Social Worker and Certified Alcohol and Drug Counselor. I work with individuals ages 16 years or older experiencing substance use issues, trauma, anxiety, depression, life adjustments, and other mood related issues. I truly believe that everyone is doing the best they can, but sometimes we need help overcoming mental and emotional challenges.
Currently accepting new clients from Iowa and Nebraska. Immediate openings available. I am a Clinical Social Worker and Certified Alcohol and Drug Counselor. I work with individuals ages 16 years or older experiencing substance use issues, trauma, anxiety, depression, life adjustments, and other mood related issues. I truly believe that everyone is doing the best they can, but sometimes we need help overcoming mental and emotional challenges.
(712) 430-7113 View (712) 430-7113
Photo of Rebecca Simoni-Ryan, LMHC, IADC, Counselor
Rebecca Simoni-Ryan
Counselor, LMHC, IADC
Verified Verified
2 Endorsed
Sioux City, IA 51108
Hello, I am the owner of Prairie River Counseling. At Prairie River Counseling I aim to take counseling beyond the office with the intent to reconnect with the natural systems around us. Providing ecotherapy with a variety of evidence-based methods to support and hold space for the client’s growth and goals. My name is Becky Simoni, and I am a licensed mental health counselor and certified substance abuse counselor (LMHC and IADC). I am currently licensed in the state of IA and NE. I am not just a traditional therapist but also an eco-therapist that practices from a holistic and evidence-based viewpoint of therapy.
Hello, I am the owner of Prairie River Counseling. At Prairie River Counseling I aim to take counseling beyond the office with the intent to reconnect with the natural systems around us. Providing ecotherapy with a variety of evidence-based methods to support and hold space for the client’s growth and goals. My name is Becky Simoni, and I am a licensed mental health counselor and certified substance abuse counselor (LMHC and IADC). I am currently licensed in the state of IA and NE. I am not just a traditional therapist but also an eco-therapist that practices from a holistic and evidence-based viewpoint of therapy.
(712) 218-3218 View (712) 218-3218
Photo of Joshua M Olson, LMHC, LPC, LMHP, Counselor
Joshua M Olson
Counselor, LMHC, LPC, LMHP
Verified Verified
Sioux City, IA 51101
We will work best together if you are motivated to change. With us both working hard for your benefit, you will achieve rapid results. The method of therapy that works best for this approach is one of my areas of specialization, and it is called Solution Focused Brief Therapy (SFBT). Whether you are hoping to recover from past trauma or abuse, whether you are working to overcome your depression or anxiety, to increase your self-esteem or confidence, you can do it, and we will develop a plan tailored to you. Alternatively, if you are seeking guidance or support involving a relationship, I'm happy to work with couples or families.
We will work best together if you are motivated to change. With us both working hard for your benefit, you will achieve rapid results. The method of therapy that works best for this approach is one of my areas of specialization, and it is called Solution Focused Brief Therapy (SFBT). Whether you are hoping to recover from past trauma or abuse, whether you are working to overcome your depression or anxiety, to increase your self-esteem or confidence, you can do it, and we will develop a plan tailored to you. Alternatively, if you are seeking guidance or support involving a relationship, I'm happy to work with couples or families.
(712) 625-6402 View (712) 625-6402
Photo of Dr. John B Dilley, Psychologist
Dr. John B Dilley
Psychologist
Verified Verified
Panora, IA 50216  (Online Only)
The body, spirit, and mind are integrated, so that philosophy permeates my work. I typically use a cognitive behavioral therapy approach, though also include other effective remedies in working with all ages-- children, teens, adults, couples, families. Common telehealth issues include depression, anxiety, panic, impulse control, behavior modification, vocational difficulties, communication, stress, intrafamily conflict, marital and/or divorce, blended families, sports psychology, etc.
The body, spirit, and mind are integrated, so that philosophy permeates my work. I typically use a cognitive behavioral therapy approach, though also include other effective remedies in working with all ages-- children, teens, adults, couples, families. Common telehealth issues include depression, anxiety, panic, impulse control, behavior modification, vocational difficulties, communication, stress, intrafamily conflict, marital and/or divorce, blended families, sports psychology, etc.
(515) 238-1602 View (515) 238-1602
Photo of Joseli Alves-Dunkerson - Relationship & Intimacy Center, Marriage & Family Therapist
Relationship & Intimacy Center
Marriage & Family Therapist
Verified Verified
West Des Moines, IA 50266
We are starting to also see kids and teens for $40/session. Scheduling is available online through our website. Do you feel sad and worried? Are you seeking personal growth or facing a personal crisis? Are you feeling stuck with the pandemic? Or maybe trying to overcome past experiences? Maybe you are dealing with issues related to your relationships, or going through intimacy issues? Or trying to better understand the online dating scene? Or would you prefer to participate in online group therapy or workshops to learn practical life strategies to deal with common problems?
We are starting to also see kids and teens for $40/session. Scheduling is available online through our website. Do you feel sad and worried? Are you seeking personal growth or facing a personal crisis? Are you feeling stuck with the pandemic? Or maybe trying to overcome past experiences? Maybe you are dealing with issues related to your relationships, or going through intimacy issues? Or trying to better understand the online dating scene? Or would you prefer to participate in online group therapy or workshops to learn practical life strategies to deal with common problems?
(515) 297-7051 View (515) 297-7051
Photo of Anna Patch, LMSW, Clinical Social Work/Therapist
Anna Patch
Clinical Social Work/Therapist, LMSW
Verified Verified
2 Endorsed
Des Moines, IA 50312
Welcome ! Reaching out to a therapist is a big step and I'm glad you're here. At times, the world can be scary, isolating and overwhelming. As a result, we may feel disconnected from ourselves and others, and may seek support, including therapy, to process, cope and reconnect. My therapeutic style is warm, collaborative and candid. You can expect me to encourage as well as gently challenge you as you grow towards your goals. I hope you will leave each session with more self-awareness and self-compassion, as well as with tangible tools and strategies you can use to improve your mental health and relationships.
Welcome ! Reaching out to a therapist is a big step and I'm glad you're here. At times, the world can be scary, isolating and overwhelming. As a result, we may feel disconnected from ourselves and others, and may seek support, including therapy, to process, cope and reconnect. My therapeutic style is warm, collaborative and candid. You can expect me to encourage as well as gently challenge you as you grow towards your goals. I hope you will leave each session with more self-awareness and self-compassion, as well as with tangible tools and strategies you can use to improve your mental health and relationships.
(515) 585-9760 View (515) 585-9760
Amanda Seemann
Counselor
Verified Verified
Des Moines, IA 50309  (Online Only)
My ideal client seeks self-exploration & understanding, facing issues like anxiety, depression, or relationship difficulties. They need a supportive space for personal growth, aiming to gain insight, develop coping strategies, improve communication, & foster healthy relationships. They aspire to enhance mental well-being, achieve a better life quality, & unlock their full potential.
My ideal client seeks self-exploration & understanding, facing issues like anxiety, depression, or relationship difficulties. They need a supportive space for personal growth, aiming to gain insight, develop coping strategies, improve communication, & foster healthy relationships. They aspire to enhance mental well-being, achieve a better life quality, & unlock their full potential.
(515) 493-7595 View (515) 493-7595
Photo of Kari Davis, LMSW, Clinical Social Work/Therapist
Kari Davis
Clinical Social Work/Therapist, LMSW
Verified Verified
1 Endorsed
West Des Moines, IA 50265  (Online Only)
I am a Licensed Master of Social Work in both Iowa and Indiana and have a significant history of working with children, families, and older adults who have experienced trauma. I have worked in a variety of settings including residential, in-home, and nursing facilities. I have experience working with all different ages, families, and individuals with a variety of needs. I am currently working on obtaining my Independent Licensure and excited to be a part of your journey! Treatment will be guided by you with the support of me.
I am a Licensed Master of Social Work in both Iowa and Indiana and have a significant history of working with children, families, and older adults who have experienced trauma. I have worked in a variety of settings including residential, in-home, and nursing facilities. I have experience working with all different ages, families, and individuals with a variety of needs. I am currently working on obtaining my Independent Licensure and excited to be a part of your journey! Treatment will be guided by you with the support of me.
(812) 445-6255 View (812) 445-6255
Photo of Kyla Loucks, LMHC, Counselor
Kyla Loucks
Counselor, LMHC
Verified Verified
3 Endorsed
West Des Moines, IA 50266
How we deal with stress can bring out what seems like the worst in us or help us to learn, grow and thrive. My goal as a therapist is to offer the space to explore your current struggles in a way that helps you learn from your past, in order to find emotional balance and self-acceptance.
How we deal with stress can bring out what seems like the worst in us or help us to learn, grow and thrive. My goal as a therapist is to offer the space to explore your current struggles in a way that helps you learn from your past, in order to find emotional balance and self-acceptance.
(515) 320-8289 View (515) 320-8289
Photo of Abraham (Abe) Goetz, LISW, CADC, Clinical Social Work/Therapist
Abraham (Abe) Goetz
Clinical Social Work/Therapist, LISW, CADC
Verified Verified
1 Endorsed
West Des Moines, IA 50265
If you are looking for a therapist with a blank, neutral face who gives an occasional "mhm" while you vent for 50 minutes, I'm not your guy. If you're looking for a guide who'll work alongside you, support you, but also be realistic and direct with you when needed, I think we would make a good team. My goal is to empower my clients to find the tools and strategies they already have within themselves, cutting through the noise and bringing those to the surface. I firmly believe in a mutually honest and direct therapeutic relationship. I will be direct with you throughout our session, and I ask you to be equally as direct with me.
If you are looking for a therapist with a blank, neutral face who gives an occasional "mhm" while you vent for 50 minutes, I'm not your guy. If you're looking for a guide who'll work alongside you, support you, but also be realistic and direct with you when needed, I think we would make a good team. My goal is to empower my clients to find the tools and strategies they already have within themselves, cutting through the noise and bringing those to the surface. I firmly believe in a mutually honest and direct therapeutic relationship. I will be direct with you throughout our session, and I ask you to be equally as direct with me.
(515) 516-4681 View (515) 516-4681

See more therapy options for Carroll

How does your Therapist compare?

Number of Therapists in Carroll, IA

< 10

Therapists in Carroll, IA who prioritize treating:

89% Depression
89% Anxiety
89% Trauma and PTSD
78% Coping Skills
78% Stress
67% Addiction
67% Grief

Average years in practice

11 Years

Top 3 insurances accepted

100% Wellmark BCBS
88% UnitedHealthcare UHC | UBH
75% Medicaid

How Therapists in Carroll, IA see their clients

89% In Person and Online
11% Online Only

Gender breakdown

100% Female
FAQs - About Therapy and Counseling

How can I find a therapist in Carroll?

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.