Therapists in Columbus, OH
![Photo of Katie Gunter, MS, LPCC-S](https://photos.psychologytoday.com/e8d59b41-3923-46ab-8f34-c58e88eab4d5/2/320x400.jpeg)
While I have treated a variety of client concerns, I am most passionate about helping survivors of sexual trauma, racial trauma, and those who have experienced incarceration. Helping survivors heal from past pain is something I focus on in sessions. I have worked in a variety of settings including schools, inpatient psychiatric hospitals, and outpatient counseling. I have experience with treating substance abuse, psychosis and thinking disorders, as well as personality and mood disorders. I have worked with all ages of clients but now focus on seeing adults.
While I have treated a variety of client concerns, I am most passionate about helping survivors of sexual trauma, racial trauma, and those who have experienced incarceration. Helping survivors heal from past pain is something I focus on in sessions. I have worked in a variety of settings including schools, inpatient psychiatric hospitals, and outpatient counseling. I have experience with treating substance abuse, psychosis and thinking disorders, as well as personality and mood disorders. I have worked with all ages of clients but now focus on seeing adults.
I believe that as people we are motivated by connection and relationships. Therapy can be a great way to explore what a healthy and collaborative relationship can be like, which can then be translated to behaviors in your daily life. I also invite discussions of identity, culture, and oppression, and how each may impact your lived experience. My aspiration is to walk alongside you in your counseling journey, tailoring sessions and interventions to help you meet your goals.
I believe that as people we are motivated by connection and relationships. Therapy can be a great way to explore what a healthy and collaborative relationship can be like, which can then be translated to behaviors in your daily life. I also invite discussions of identity, culture, and oppression, and how each may impact your lived experience. My aspiration is to walk alongside you in your counseling journey, tailoring sessions and interventions to help you meet your goals.
![Photo of Taylor Adams, MA, LPC, EMDR, Licensed Professional Counselor](https://photos.psychologytoday.com/a2a32221-da91-4c8b-afdd-52d183bdd1d7/3/320x400.jpeg)
Taylor Adams
Licensed Professional Counselor, MA, LPC, EMDR
Verified Verified
Columbus, OH 43229 (Online Only)
My dream client is someone who finds themselves in the midst of life's intricate maze, trying to balance the many demands of work, relationships, and self-care. They might be grappling with stress, anxiety, and the emotional ups and downs that come with it all. They're yearning for a warm, understanding companion to walk with them on their journey. Whether they're navigating a new life transition or facing a persistent inner struggle, my ideal client seeks relief and effective strategies to move forward towards a more fulfilling life.
My dream client is someone who finds themselves in the midst of life's intricate maze, trying to balance the many demands of work, relationships, and self-care. They might be grappling with stress, anxiety, and the emotional ups and downs that come with it all. They're yearning for a warm, understanding companion to walk with them on their journey. Whether they're navigating a new life transition or facing a persistent inner struggle, my ideal client seeks relief and effective strategies to move forward towards a more fulfilling life.
![Photo of Gina M Menninger, MFTT , Marriage & Family Therapist Intern](https://photos.psychologytoday.com/d87f9368-5a97-415f-bdfc-4ba55ad1686d/1/320x400.jpeg)
Our time together in session is a thoughtful and collaborative process where we work towards building trust in a safe and non-judgmental environment, regardless of race, gender, religion, ethnicity, sexual orientation, or background. My primary objective as a marriage and family therapist is to give you the tools you need to move forward in your life. I have personal and professional experience with individuals, couples, children, adolescents, and families living with chronic pain, anxiety, depression, personality disorders, PTSD, ADHD, divorce, infidelity, and OCD.
Our time together in session is a thoughtful and collaborative process where we work towards building trust in a safe and non-judgmental environment, regardless of race, gender, religion, ethnicity, sexual orientation, or background. My primary objective as a marriage and family therapist is to give you the tools you need to move forward in your life. I have personal and professional experience with individuals, couples, children, adolescents, and families living with chronic pain, anxiety, depression, personality disorders, PTSD, ADHD, divorce, infidelity, and OCD.
![Photo of Jessica Ketner, MS, IMFT, Marriage & Family Therapist](https://photos.psychologytoday.com/3da5b163-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
I provide psychotherapy for couples, families, individual adults, adolescents and children. I collaborate with my clients, from an integrative client-centered approach, to treat a variety of mental, emotional and relational issues. I value the strengths that my clients bring with them to the therapy room and guide them to build on those attributes to create change in their lives. I work with clients who struggle with anxiety, depression, OCD, body image, infidelity, marital distress, grief and loss, challenging life transitions and other issues.
I provide psychotherapy for couples, families, individual adults, adolescents and children. I collaborate with my clients, from an integrative client-centered approach, to treat a variety of mental, emotional and relational issues. I value the strengths that my clients bring with them to the therapy room and guide them to build on those attributes to create change in their lives. I work with clients who struggle with anxiety, depression, OCD, body image, infidelity, marital distress, grief and loss, challenging life transitions and other issues.
![Photo of Karla Lebron-Rivera Spanish-English, LISW-S, Clinical Social Work/Therapist](https://photos.psychologytoday.com/8d63d3b7-bbb1-4b3a-a962-53bd69633d27/2/320x400.jpeg)
Karla Lebron-Rivera Spanish-English
Clinical Social Work/Therapist, LISW-S
Verified Verified
1 Endorsed
Columbus, OH 43213 (Online Only)
Currently accepting new clients (evenings and weekends). I know that finding the right therapist could be overwhelming, but allow me to help you in this process that is very important for you. I believe that the connection and collaboration with your therapist is one important piece in a good therapeutic alliance. It is important for me that you feel heard and that you can work toward your personal goals. I am a Bilingual (English/Spanish) therapist offering teletherapy for teens and adults. I work with people that are experiencing relationship issues, anxiety, depression, stress, trauma, life transitions, low self esteem and grief.
Currently accepting new clients (evenings and weekends). I know that finding the right therapist could be overwhelming, but allow me to help you in this process that is very important for you. I believe that the connection and collaboration with your therapist is one important piece in a good therapeutic alliance. It is important for me that you feel heard and that you can work toward your personal goals. I am a Bilingual (English/Spanish) therapist offering teletherapy for teens and adults. I work with people that are experiencing relationship issues, anxiety, depression, stress, trauma, life transitions, low self esteem and grief.
![Photo of Tyler Pemberton, LISW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/4a833d67-4ce2-42bf-8d95-6540ab0f10cf/1/320x400.jpeg)
I am a LISW with a Master of Social Work from The Ohio State University. My areas of professional interest include anxiety management, ADHD/neurodivergence, life transitions, family/relationship conflict, and stress. I use the following therapeutic approaches: CBT (Cognitive Behavioral Therapy), Motivational Interviewing, Solution Focused Therapy, Culturally Sensitive Therapy, and Collaborative Problem Solving.
I am a LISW with a Master of Social Work from The Ohio State University. My areas of professional interest include anxiety management, ADHD/neurodivergence, life transitions, family/relationship conflict, and stress. I use the following therapeutic approaches: CBT (Cognitive Behavioral Therapy), Motivational Interviewing, Solution Focused Therapy, Culturally Sensitive Therapy, and Collaborative Problem Solving.
![Photo of Shannon N Evans, MS, LPCC-S, Counselor](https://photos.psychologytoday.com/7a289d73-c1b4-41cc-9f53-2bcb86c1cce6/1/320x400.jpeg)
Shannon N Evans
Counselor, MS, LPCC-S
Verified Verified
Columbus, OH 43219 (Online Only)
Not accepting new clients
I would like to meet you and use my skills as a Licensed Professional Clinical Counselor to work collaboratively with you. Together we can unlock your solutions to work and/or family stressors, depression, anxiety, maintaining recovery, dealing with trauma and other issues that effect so many of us in our day to day lives. Your journey is toward wellness and seeking out a well-trained clinician is your first step toward achieving your goal.
I would like to meet you and use my skills as a Licensed Professional Clinical Counselor to work collaboratively with you. Together we can unlock your solutions to work and/or family stressors, depression, anxiety, maintaining recovery, dealing with trauma and other issues that effect so many of us in our day to day lives. Your journey is toward wellness and seeking out a well-trained clinician is your first step toward achieving your goal.
![Photo of Kelsie A Salmen, PsyD, Psychologist](https://photos.psychologytoday.com/5060f062-4f08-4710-ac3e-01a19217ff36/3/320x400.jpeg)
Dr. Salmen's approach to therapy is one that places great value on the therapeutic relationship. When a strong and trusting working relationship is built, clients are able to feel safe to express themselves, share their fears, celebrate their successes, and set important and attainable goals. Dr. Salmen's therapeutic style is a blend of techniques, which can be tailored to fit each client's unique needs. These techniques include psychodynamic psychotherapy, Cognitive-Behavioral Therapy (CBT), and interpersonal and relational approaches.
Dr. Salmen's approach to therapy is one that places great value on the therapeutic relationship. When a strong and trusting working relationship is built, clients are able to feel safe to express themselves, share their fears, celebrate their successes, and set important and attainable goals. Dr. Salmen's therapeutic style is a blend of techniques, which can be tailored to fit each client's unique needs. These techniques include psychodynamic psychotherapy, Cognitive-Behavioral Therapy (CBT), and interpersonal and relational approaches.
![Photo of Danya Contractor, LPC, MA, Licensed Professional Counselor](https://photos.psychologytoday.com/d356d118-30f6-4896-b8cd-99bf2ad040d6/2/320x400.jpeg)
Danya Contractor
Licensed Professional Counselor, LPC, MA
Verified Verified
4 Endorsed
Columbus, OH 43212 (Online Only)
Hi, I’m Danya. I believe that everyone has the potential to transform their life. If there is something about your life that you wish to change, I will meet you with respect, humility, and clinical expertise. There is no “ideal client” for me, but we will work well together if you are curious, open-minded, and actively engaged in sessions. If you appreciate candid and compassionate communication, we might be a good match. Whatever you are dealing with, I’m here to listen and support. As your counselor, I'll work to provide a nonjudgmental space to safely explore your emotions, thoughts, identities, and experiences together.
Hi, I’m Danya. I believe that everyone has the potential to transform their life. If there is something about your life that you wish to change, I will meet you with respect, humility, and clinical expertise. There is no “ideal client” for me, but we will work well together if you are curious, open-minded, and actively engaged in sessions. If you appreciate candid and compassionate communication, we might be a good match. Whatever you are dealing with, I’m here to listen and support. As your counselor, I'll work to provide a nonjudgmental space to safely explore your emotions, thoughts, identities, and experiences together.
![Photo of Shelby Cook - Cook Counseling and Consulting Inc., MSW, LISW-S, LCSW-QS, CCTP, Clinical Social Work/Therapist](https://photos.psychologytoday.com/ff2f8d0e-5a92-4035-8c6e-b4fa48f41dea/1/320x400.jpeg)
Cook Counseling and Consulting Inc.
Clinical Social Work/Therapist, MSW, LISW-S, LCSW-QS, CCTP
Verified Verified
3 Endorsed
Columbus, OH 43230
Hi there! We are Cook Counseling and Consulting Inc., a group of psychotherapists with diverse experiences and specialties. We work with clients with various concerns, including depression, anxiety, relationship issues, career challenges, BPD, and trauma. We use a combination of Cognitive Behavioral (CBT), Cognitive Processing (CPT), Dialectical (DBT), Couples Therapy, and Trauma Focused therapies. We believe in treating everyone with respect and working with clients and couples to identify strengths and develop the skills to navigate life's challenges. We also offer supervision for LSWs seeking independent licensure.
Hi there! We are Cook Counseling and Consulting Inc., a group of psychotherapists with diverse experiences and specialties. We work with clients with various concerns, including depression, anxiety, relationship issues, career challenges, BPD, and trauma. We use a combination of Cognitive Behavioral (CBT), Cognitive Processing (CPT), Dialectical (DBT), Couples Therapy, and Trauma Focused therapies. We believe in treating everyone with respect and working with clients and couples to identify strengths and develop the skills to navigate life's challenges. We also offer supervision for LSWs seeking independent licensure.
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Victory Mental Health Services of Columbus
![Photo of Madison Piehl, PhD, Psychologist](https://photos.psychologytoday.com/73151419-9f93-4f9c-9543-c3ef0eea42d7/2/320x400.jpeg)
I work with adults using Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) to treat a wide range of eating-related concerns, as well as anxiety, depression, and associated conditions. I also provide Cognitive Processing Therapy (CPT) for adults seeking trauma therapy, and I provide couples therapy using Integrative Behavioral Couple Therapy (IBCT).
I work with adults using Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) to treat a wide range of eating-related concerns, as well as anxiety, depression, and associated conditions. I also provide Cognitive Processing Therapy (CPT) for adults seeking trauma therapy, and I provide couples therapy using Integrative Behavioral Couple Therapy (IBCT).
![Photo of Megan Donelan, MA, LPCC](https://photos.psychologytoday.com/b8982362-7fae-404f-9849-1ea4793bcb88/2/320x400.jpeg)
Megan Donelan
Licensed Professional Clinical Counselor, MA, LPCC
Verified Verified
Columbus, OH 43220 (Online Only)
Megan doesn't believe clients need to "wait until something is wrong" to start therapy and supports clients in building their distress tolerance against everyday stressors. She prioritizes making clients feel comfortable, safe, and at ease during sessions and collaborates with the client for individualized treatment. She specializes in anxiety, attachment, trauma, and previously provided counseling in residential eating disorder treatment but provides support for a wide range of concerns. Many of her clients are new to therapy, and she enjoys making therapy a positive, effective experience.
Megan doesn't believe clients need to "wait until something is wrong" to start therapy and supports clients in building their distress tolerance against everyday stressors. She prioritizes making clients feel comfortable, safe, and at ease during sessions and collaborates with the client for individualized treatment. She specializes in anxiety, attachment, trauma, and previously provided counseling in residential eating disorder treatment but provides support for a wide range of concerns. Many of her clients are new to therapy, and she enjoys making therapy a positive, effective experience.
![Photo of Stephen Duraney, MA, LPCC-S, LICDC, CIT](https://photos.psychologytoday.com/d7d741cb-e0e3-4c5d-999c-05cbbc7694ee/2/320x400.jpeg)
Stephen Duraney
Licensed Professional Clinical Counselor, MA, LPCC-S, LICDC, CIT
Verified Verified
1 Endorsed
Columbus, OH 43231
I have a heart for helping people develop their inner strength, build deeper relationships with the people around them, and rediscover their joy... In addition, I enjoy getting to learn from clients each day and the personal growth that comes with accompanying you on the journey toward healing.
I have a heart for helping people develop their inner strength, build deeper relationships with the people around them, and rediscover their joy... In addition, I enjoy getting to learn from clients each day and the personal growth that comes with accompanying you on the journey toward healing.
![Photo of Linda Sue Powell - Ageless Counseling, MSW, MBA, LISW-S, Clinical Social Work/Therapist](https://photos.psychologytoday.com/46bbf016-46cd-11ea-a6ad-06142c356176/3/320x400.jpeg)
Ageless Counseling
Clinical Social Work/Therapist, MSW, MBA, LISW-S
Verified Verified
Columbus, OH 43213
Waitlist for new clients
I work with older adults and/or caregivers about the aging process, adjustment and the many changes associated with growing old and all the grief and loss experienced at this time in their lives. I also work with all adults on a variety of issues and concerns: depression, anxiety, PTSD, grief, and others.
I work with older adults and/or caregivers about the aging process, adjustment and the many changes associated with growing old and all the grief and loss experienced at this time in their lives. I also work with all adults on a variety of issues and concerns: depression, anxiety, PTSD, grief, and others.
![Photo of Megan Webster, MSW, LISW-S, Clinical Social Work/Therapist](https://photos.psychologytoday.com/3f2a8093-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
Megan Webster
Clinical Social Work/Therapist, MSW, LISW-S
Verified Verified
Columbus, OH 43220 (Online Only)
I view counseling as a partnership between an individual or family and their therapist. When the theraputic relationship is strong I believe much can be accomplished. I work with individuals, adolescents and families as a partner in the process of wholeness. I believe that counseling can assist in the development of an understanding of yourself, your family and enhancing important relationships in your life.
I view counseling as a partnership between an individual or family and their therapist. When the theraputic relationship is strong I believe much can be accomplished. I work with individuals, adolescents and families as a partner in the process of wholeness. I believe that counseling can assist in the development of an understanding of yourself, your family and enhancing important relationships in your life.
![Photo of Briana Wood, LSW](https://photos.psychologytoday.com/fbc38bc1-b7e5-44b8-a4b3-78bdbd4ffe06/1/320x400.jpeg)
I offer a supportive and comfortable environment and approach. We are human and we aren't always prepared on how to deal with hard things, so give this a try and see if it may help. I'm willing to meet you where you are and work alongside you to help you succeed in reaching your personal goals.
I offer a supportive and comfortable environment and approach. We are human and we aren't always prepared on how to deal with hard things, so give this a try and see if it may help. I'm willing to meet you where you are and work alongside you to help you succeed in reaching your personal goals.
![Photo of Gabrielle Plata-Madrid, MA, LPC, Pre-Licensed Professional](https://photos.psychologytoday.com/bee7afeb-ab51-4b39-8886-7a310f4f1d71/2/320x400.jpeg)
Gabrielle Plata-Madrid
Pre-Licensed Professional, MA, LPC
Verified Verified
Columbus, OH 43214 (Online Only)
Every client is unique; therefore, I draw from various theoretical approaches to provide optimal therapeutic care.
Every client is unique; therefore, I draw from various theoretical approaches to provide optimal therapeutic care.
![Photo of Dr. Shonali Raney, PhD, Psychologist](https://photos.psychologytoday.com/7579d1ca-48ae-49ce-9697-35785d5f8849/3/320x400.jpeg)
Dr. Shonali Raney
Psychologist, PhD
Verified Verified
4 Endorsed
Columbus, OH 43214
Not accepting new clients
I work solely with clients who are 25 years old and above. Being engaged in individual counseling is an opportunity to receive support and experience growth during challenging times of life. Counseling allows individuals to explore their feelings, beliefs, and behaviors, to address concerns that lead to mental health problems. You will work with me in a safe, caring and confidential environment. The focus of our work could be on specific goals or long-standing concerns such as, family of origin issues or past-unsolved trauma. The ultimate goal is to help you heal, grow, and re-engage in a productive, personally fulfilling life.
I work solely with clients who are 25 years old and above. Being engaged in individual counseling is an opportunity to receive support and experience growth during challenging times of life. Counseling allows individuals to explore their feelings, beliefs, and behaviors, to address concerns that lead to mental health problems. You will work with me in a safe, caring and confidential environment. The focus of our work could be on specific goals or long-standing concerns such as, family of origin issues or past-unsolved trauma. The ultimate goal is to help you heal, grow, and re-engage in a productive, personally fulfilling life.
![Photo of Jeanie Lisk, LSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/2b70098b-fe17-4c3f-9e7d-3f0dc7fdd409/1/320x400.png)
Do you feel like no one hears you? Have you been told that you are unable to be helped? Are you chronically suicidal or struggling with emotions? Do you feel like you don't fit in and are looking for a connection? Do you want to feel normal and find a connection?
Do you feel like no one hears you? Have you been told that you are unable to be helped? Are you chronically suicidal or struggling with emotions? Do you feel like you don't fit in and are looking for a connection? Do you want to feel normal and find a connection?
See more therapy options for Columbus
How does your Therapist compare?
Number of Therapists in Columbus, OH
1,000+
Average cost per session
$125
Therapists in Columbus, OH who prioritize treating:
91% | Anxiety |
86% | Depression |
72% | Trauma and PTSD |
71% | Self Esteem |
67% | Relationship Issues |
65% | Coping Skills |
62% | Stress |
Average years in practice
10 Years
Top 3 insurances accepted
84% | Aetna |
73% | UnitedHealthcare UHC | UBH |
69% | Cigna and Evernorth |
How Therapists in Columbus, OH see their clients
61% | In Person and Online | |
39% | Online Only |
Gender breakdown
79% | Female | |
20% | Male | |
1% | Non-Binary |
FAQs - About Therapy and Counseling
How can I find a therapist in Columbus?
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.