Therapists in Winston Salem, NC
Thank you for considering working with me as your counselor. I work individually and in groups with adolescents, adults, couples and families. I approach counseling from a person-centered theoretical background, meaning I believe that each person has within themselves the tools to grow, change, heal and improve. It is my goal to help individuals access those personal resources and grow in their personal self-efficacy. Self-awareness and self-efficacy, while goals in the counseling relationship, are difficult to achieve and will take time, energy, and client engagement. Clients will feel that they are able to face life's challenges.
Thank you for considering working with me as your counselor. I work individually and in groups with adolescents, adults, couples and families. I approach counseling from a person-centered theoretical background, meaning I believe that each person has within themselves the tools to grow, change, heal and improve. It is my goal to help individuals access those personal resources and grow in their personal self-efficacy. Self-awareness and self-efficacy, while goals in the counseling relationship, are difficult to achieve and will take time, energy, and client engagement. Clients will feel that they are able to face life's challenges.
Redfish Counseling
Licensed Professional Counselor, LCMHC
Verified Verified
5 Endorsed
Winston Salem, NC 27101
You're tired of feeling stuck, hurt, confused, and lost. Life has stalled out because of relationship static, family stress, anxiety, career crisis, addiction, lost hope, or past events that keep you running in circles. Each day feels like you're walking on eggshells. Sometimes you feel so cut off from yourself and those you love that you’re not sure who you are anymore, or if it's possible to figure it out. You wonder if things will ever get better and if living life with peace, joy, and renewed energy can really happen.
You're tired of feeling stuck, hurt, confused, and lost. Life has stalled out because of relationship static, family stress, anxiety, career crisis, addiction, lost hope, or past events that keep you running in circles. Each day feels like you're walking on eggshells. Sometimes you feel so cut off from yourself and those you love that you’re not sure who you are anymore, or if it's possible to figure it out. You wonder if things will ever get better and if living life with peace, joy, and renewed energy can really happen.
Angela Mauldin
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
2 Endorsed
Winston Salem, NC 27103
Do you often find it difficult to make decisions or resolve issues that weigh you down? Do you feel stuck in a cycle of anxiety, struggling to cope with grief, or perhaps stressed out by relationships? I am a Licensed Clinical Social Worker and Certified Life Coach committed to helping people learn how to find the pathways that lead to healthier relationships and build effective strategies to overcome struggles.
Do you often find it difficult to make decisions or resolve issues that weigh you down? Do you feel stuck in a cycle of anxiety, struggling to cope with grief, or perhaps stressed out by relationships? I am a Licensed Clinical Social Worker and Certified Life Coach committed to helping people learn how to find the pathways that lead to healthier relationships and build effective strategies to overcome struggles.
Camel City Counseling
Licensed Professional Counselor, LCMHC
Verified Verified
14 Endorsed
Winston Salem, NC 27101
We are a diverse practice, with locations in Lake Norman and Winston-Salem, that provides psychotherapy in person or online, psychological evaluations, consulting services, and clinical supervision in NC. We serve children ages 3 and up, families, teens, couples and adults. We also provide educational consulting for 504/IEP planning. Our organizational consulting services help leadership teams grow and learn and our private practice consulting helps clinicians ready to take the leap into private practice. Our clinical supervision services are available to LCMHCA's, LCSWA's, and LPA's in NC.
We are a diverse practice, with locations in Lake Norman and Winston-Salem, that provides psychotherapy in person or online, psychological evaluations, consulting services, and clinical supervision in NC. We serve children ages 3 and up, families, teens, couples and adults. We also provide educational consulting for 504/IEP planning. Our organizational consulting services help leadership teams grow and learn and our private practice consulting helps clinicians ready to take the leap into private practice. Our clinical supervision services are available to LCMHCA's, LCSWA's, and LPA's in NC.
I provide creative care that celebrates all identities. I primarily work with emerging adults and teens 15+ to help navigate an exciting phase of life filled with new transitions and challenges. I am passionate about working with those who have experienced interpersonal trauma such as sexual assault, intimate partner violence, and human trafficking. While allowing you to take the lead on your therapeutic journey, I will support you through healing, self-discovery, and coping with distressing feelings and experiences. I am committed to considering the impact of identity, oppression, and societal systems on your concerns.
I provide creative care that celebrates all identities. I primarily work with emerging adults and teens 15+ to help navigate an exciting phase of life filled with new transitions and challenges. I am passionate about working with those who have experienced interpersonal trauma such as sexual assault, intimate partner violence, and human trafficking. While allowing you to take the lead on your therapeutic journey, I will support you through healing, self-discovery, and coping with distressing feelings and experiences. I am committed to considering the impact of identity, oppression, and societal systems on your concerns.
Katherine Myers
Clinical Social Work/Therapist, LCSW, LICSW, CEDS
Verified Verified
3 Endorsed
Winston Salem, NC 27104 (Online Only)
Maybe you have waited a long time to seek help and suffered in silence. Perhaps you've become accustomed to this discomfort or a pain. Or maybe you desire change through seeking understanding and want a greater sense of wellbeing. Therapy may help you with this process of personal growth and healing. Whether you have a crisis, traumatic experience, significant life challenge or are wanting to experience greater fulfillment therapy may be for you.
Maybe you have waited a long time to seek help and suffered in silence. Perhaps you've become accustomed to this discomfort or a pain. Or maybe you desire change through seeking understanding and want a greater sense of wellbeing. Therapy may help you with this process of personal growth and healing. Whether you have a crisis, traumatic experience, significant life challenge or are wanting to experience greater fulfillment therapy may be for you.
Marriage need a tuneup? Feeling overwhelmed? Anxious? Depressed? .... I can help. If you are looking for someone who can guide you through a change process, and you are ready to do what it takes, let's talk. I serve the Piedmont Triad area, and can also meet with you via Tele-counseling from anywhere in NC. Why wait any longer? Just pick up the phone and call. Let's talk about your needs, challenges and goals. We can then determine if my skills and experience are right for you.
Marriage need a tuneup? Feeling overwhelmed? Anxious? Depressed? .... I can help. If you are looking for someone who can guide you through a change process, and you are ready to do what it takes, let's talk. I serve the Piedmont Triad area, and can also meet with you via Tele-counseling from anywhere in NC. Why wait any longer? Just pick up the phone and call. Let's talk about your needs, challenges and goals. We can then determine if my skills and experience are right for you.
Elaine Pendergrass
LCSW Associate , LCSWA, MSW, PMP
Verified Verified
1 Endorsed
Winston Salem, NC 27103
I specialize in life transitions, such as moving from high school to college, entering the workforce, changing careers, or adjusting to an empty nest. I also specialize in working with neurodivergent individuals, including those with ADHD, OCD, autism, and AuDHD. I serve children, young adults, families, and seniors. If you feel overwhelmed, stuck, or unsure about the next step, you are not alone—and you don’t have to figure it out alone either. With lived experience and a toolbox of resources, I’ll walk alongside you to find clarity, build confidence, and create a path forward that works for you.
I specialize in life transitions, such as moving from high school to college, entering the workforce, changing careers, or adjusting to an empty nest. I also specialize in working with neurodivergent individuals, including those with ADHD, OCD, autism, and AuDHD. I serve children, young adults, families, and seniors. If you feel overwhelmed, stuck, or unsure about the next step, you are not alone—and you don’t have to figure it out alone either. With lived experience and a toolbox of resources, I’ll walk alongside you to find clarity, build confidence, and create a path forward that works for you.
Fulcrum Counseling and Consultation, PLLC
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
2 Endorsed
Winston Salem, NC 27101
I'm so glad you're here! If you're looking for a therapist that means that you're considering a change in your life. Something isn't working the way you want it to; whether that's interpersonal relationships, work, school, or just the way you feel about yourself. If you're ready to work on finding balance and making some changes, then I would love to hear from you.
I'm so glad you're here! If you're looking for a therapist that means that you're considering a change in your life. Something isn't working the way you want it to; whether that's interpersonal relationships, work, school, or just the way you feel about yourself. If you're ready to work on finding balance and making some changes, then I would love to hear from you.
Hello and welcome! Here’s what you need to know about me: I received a Master of Arts from Appalachian State University in Clinical Mental Health Counseling, concentrating in Addictions Counseling. I am a Licensed Clinical Mental Health Counselor Associate and am working towards becoming a Licensed Clinical Addictions Specialist Associate. What does all of that mean? I have the formal training to provide counseling. I also hold marginal identities that have led to my own lived experiences with counseling; I know how hard this work can be.
Hello and welcome! Here’s what you need to know about me: I received a Master of Arts from Appalachian State University in Clinical Mental Health Counseling, concentrating in Addictions Counseling. I am a Licensed Clinical Mental Health Counselor Associate and am working towards becoming a Licensed Clinical Addictions Specialist Associate. What does all of that mean? I have the formal training to provide counseling. I also hold marginal identities that have led to my own lived experiences with counseling; I know how hard this work can be.
Kathleen J. McFadden
Licensed Clinical Mental Health Counselor, MS, MTS, LCMHC
Verified Verified
Winston Salem, NC 27101
Is your deepest desire true connection? ... AND your greatest fear? Let me help you release those false beliefs and transform your relationships with the most effective trauma therapies. I practice NARM, EMDR 2.0, Psychodrama and various other modalities. Developmental trauma and/or chronic trauma (CPTSD) can set deeply entrenched patterns of behavior that traditionally are hard to shift with just talk therapy. Most clients see real shifts in their behaviors and relationships that not only allow them to feel better, but actually start to thrive, not just survive.
Is your deepest desire true connection? ... AND your greatest fear? Let me help you release those false beliefs and transform your relationships with the most effective trauma therapies. I practice NARM, EMDR 2.0, Psychodrama and various other modalities. Developmental trauma and/or chronic trauma (CPTSD) can set deeply entrenched patterns of behavior that traditionally are hard to shift with just talk therapy. Most clients see real shifts in their behaviors and relationships that not only allow them to feel better, but actually start to thrive, not just survive.
15 Second Videos
Redfish Counseling
Angela Mauldin
Elaine Pendergrass
Jared Brinkerhoff
Sydney Elder
Naomi's Branch PLLC
Rebecca Rugh-Webb
Banyan Tree Counseling & Wellness
Kelsey Catherwood
Rhonda Ferrell
William (Stacey) Steck
Stonebuilders Counseling Center, Inc.
Susannah S Cecil
Emily Wilhoit
Brittany E. Wyche
Andrea Lein
Aileen Lassiter
James H. Tunstall IV
Christopher J. Koniarczyk
Amanda Beck
Brittany Johnson Todd
Erin Elliott
J Stack
Maleah Koppa
David Stefan Bathory
Meg Anderson
James Wise
David Leonard
Hannah Dillon
Arnold Joseph Colamarino
Tiffany Franzo
Georgie Lazarus
Ricky A Speller
Thriveworks Counseling & Psychiatry Winston-Salem
Dominique Correa Mood disorders Marriage And Family Therapy
Green Center Therapy
Amber Turlik
Rachelle Evans Burrell
Esther Mendez
Brooke Reiner
Ashton Burdick
Travis Jeffords
Maggie Latta-Milord
Tobias Everett LaGrone D. Min.
Maria Paredes
Valarie Anne Snell
Higher Level Life Coaching & Soul Care, LLC
Rossana L Magalhaes
Nicole Wallace
Jessie Cockerham
Jared Brinkerhoff
Licensed Professional Counselor, MS, NCC, LCMHC
Verified Verified
1 Endorsed
Winston Salem, NC 27103
There are so many reasons that therapy can be right for you, ranging from daily stressors to massive life events or transitions. Who knows, there might even be a global pandemic or two thrown in just to keep things interesting. Whether your path forward through difficult times is clear and you just want to process the changes, or maybe you can't see the light and need someone to help you find your way, I am happy to go on that journey with you. Because therapy is a truly tough thing, my "ideal" clients are simply willing to give their best effort and commit to the process.
There are so many reasons that therapy can be right for you, ranging from daily stressors to massive life events or transitions. Who knows, there might even be a global pandemic or two thrown in just to keep things interesting. Whether your path forward through difficult times is clear and you just want to process the changes, or maybe you can't see the light and need someone to help you find your way, I am happy to go on that journey with you. Because therapy is a truly tough thing, my "ideal" clients are simply willing to give their best effort and commit to the process.
Jasmine Henderson Lambeth
Lic Clinical Mental Health Counselor Associate, LCMHCA
Verified Verified
Winston Salem, NC 27127
I'm a Licensed Clinical Mental Health Counselor Associate who works with Autistic children, teens, adults and their families at ABC of NC Child Development Center. I have worked with Autistic Children and Teens as an RBT; Registered Behavior Technician; for 7 years. I have experience working with school aged students and adults who have struggled with anxiety, depression, bullying, adjustment disorders, etc.
I'm a Licensed Clinical Mental Health Counselor Associate who works with Autistic children, teens, adults and their families at ABC of NC Child Development Center. I have worked with Autistic Children and Teens as an RBT; Registered Behavior Technician; for 7 years. I have experience working with school aged students and adults who have struggled with anxiety, depression, bullying, adjustment disorders, etc.
Breanna Elder Sparrow
Lic Clinical Mental Health Counselor, MA, LCMHC, CCTP
Verified Verified
Winston Salem, NC 27106
Many times people find themselves at a place in life where they find it difficult to move towards their goals in life. Goals vary from person to person; but they are important to who we are. A person may notice the same mountain is circled with little to no progress. This can be very frustrating. Obstacles might include past "hang-ups", lack of self trust, or feeling unmotivated or overwhelmed with life's circumstances. There may be times the individual wonders if things will always be a certain way, or they may wonder if there is something they are missing. They desire to move past the obstacles and achieve their goal.
Many times people find themselves at a place in life where they find it difficult to move towards their goals in life. Goals vary from person to person; but they are important to who we are. A person may notice the same mountain is circled with little to no progress. This can be very frustrating. Obstacles might include past "hang-ups", lack of self trust, or feeling unmotivated or overwhelmed with life's circumstances. There may be times the individual wonders if things will always be a certain way, or they may wonder if there is something they are missing. They desire to move past the obstacles and achieve their goal.
Starkesha Daye
Licensed Clinical Mental Health Counselor, LCMHC
Verified Verified
Winston Salem, NC 27103 (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.
Jenifer Shadrick
Licensed Clinical Mental Health Counselor, LCMHC
Verified Verified
Winston Salem, NC 27104 (Online Only)
I am a Licensed Clinical Mental Health Counselor (LCMHC). I obtained my Bachelor's degree in Psychology Christian Counseling with a minor in Special Education in 2013 from Liberty University, and then went on to graduate with a Master’s degree in Professional Counseling in 2015. I work with individuals struggling with communication, impulse control, relationships, social skills, self-esteem, anxiety, addictions, and adjustment issues.
I am a Licensed Clinical Mental Health Counselor (LCMHC). I obtained my Bachelor's degree in Psychology Christian Counseling with a minor in Special Education in 2013 from Liberty University, and then went on to graduate with a Master’s degree in Professional Counseling in 2015. I work with individuals struggling with communication, impulse control, relationships, social skills, self-esteem, anxiety, addictions, and adjustment issues.
Patricia L Owens
Licensed Professional Counselor, LCMHC, LCAS
Verified Verified
Winston Salem, NC 27103
I believe therapy can be essential for anyone seeking to improve their mental well being. Each of us have experienced our own difficulties, though they may be different, struggle is universal. It is my desire to provide a safe, unbiased, and welcoming space for you to grow to the person you want to be. In therapy I will be there to provide a listening ear and give feedback to assist you in your journey. During this time we will work as a team navigating the ups and downs together.
I believe therapy can be essential for anyone seeking to improve their mental well being. Each of us have experienced our own difficulties, though they may be different, struggle is universal. It is my desire to provide a safe, unbiased, and welcoming space for you to grow to the person you want to be. In therapy I will be there to provide a listening ear and give feedback to assist you in your journey. During this time we will work as a team navigating the ups and downs together.
Deidre Montgomery
Clinical Social Work/Therapist, MSW, LCSWA
Verified Verified
Winston Salem, NC 27101
Seeking therapeutic counseling can be challenging for any number of reasons, from being ready to take the first step on your mental health journey to finding a therapist that's right for you. Wherever you are on your path, I aim to provide a comforting, non-judgmental environment where you feel heard, valued, and comfortable being yourself. Therapy is collaborative work with your goals as the focus. The number of different therapeutic treatments out there may be overwhelming, but I can help you find what works. No matter who you are, I will work with you to reach your next step and grow while you decide what we are working towards.
Seeking therapeutic counseling can be challenging for any number of reasons, from being ready to take the first step on your mental health journey to finding a therapist that's right for you. Wherever you are on your path, I aim to provide a comforting, non-judgmental environment where you feel heard, valued, and comfortable being yourself. Therapy is collaborative work with your goals as the focus. The number of different therapeutic treatments out there may be overwhelming, but I can help you find what works. No matter who you are, I will work with you to reach your next step and grow while you decide what we are working towards.
Amanda Davis Whicker
Licensed Professional Counselor, LCMHCS
Verified Verified
Winston Salem, NC 27101
Do you ever feel something is just off and you can't put your finger on it? Do you know something is wrong and you want to talk with someone, but you don't feel comfortable talking with your friends and/or family? Are you fighting anxiety, stress, anger, grief and maybe some other issues and you want to feel better? AW Counseling is a safe place to be able to come and talk out those feelings, thoughts and emotions and be able to devleop new skills.
Do you ever feel something is just off and you can't put your finger on it? Do you know something is wrong and you want to talk with someone, but you don't feel comfortable talking with your friends and/or family? Are you fighting anxiety, stress, anger, grief and maybe some other issues and you want to feel better? AW Counseling is a safe place to be able to come and talk out those feelings, thoughts and emotions and be able to devleop new skills.
Claudia Davies
Clinical Social Work/Therapist, LCSW, TF-CBT
Verified Verified
Winston Salem, NC 27107 (Online Only)
Hello there and welcome to my safe space. I am a Licensed Clinical Social Worker and Certified Trauma Focused Cognitive Behavioral Therapist. I have several years of clinical experience working with individuals, families and groups of various ages, race, nationalities, and ethnicities. I have experience working in outpatient, psychiatric behavioral health, and hospice settings. Therapy is a partnership, and as partners, together, we will determine what therapeutic intervention(s) is best for you. My goal is to use what I know, to do what I can, to help you navigate and cope with life in whatever capacity that may look like for you.
Hello there and welcome to my safe space. I am a Licensed Clinical Social Worker and Certified Trauma Focused Cognitive Behavioral Therapist. I have several years of clinical experience working with individuals, families and groups of various ages, race, nationalities, and ethnicities. I have experience working in outpatient, psychiatric behavioral health, and hospice settings. Therapy is a partnership, and as partners, together, we will determine what therapeutic intervention(s) is best for you. My goal is to use what I know, to do what I can, to help you navigate and cope with life in whatever capacity that may look like for you.
See more therapy options for Winston Salem
Nearby Searches for Winston Salem
- Advance
- Clemmons
- High Point
- Kernersville
- King
- Lewisville
- Lexington
- Oak Ridge
- Pfafftown
- Thomasville
- Walkertown
- Walnut Cove
How does your Therapist compare?
Number of Therapists in Winston Salem, NC
500+
Average cost per session
$140
Therapists in Winston Salem, NC who prioritize treating:
92% | Anxiety |
89% | Depression |
77% | Self Esteem |
74% | Coping Skills |
73% | Relationship Issues |
73% | Stress |
71% | Trauma and PTSD |
Average years in practice
10 Years
Top 3 insurances accepted
89% | BlueCross and BlueShield |
80% | Aetna |
48% | Cigna and Evernorth |
How Therapists in Winston Salem, NC see their clients
71% | In Person and Online | |
29% | Online Only |
Gender breakdown
79% | Female | |
19% | Male | |
2% | Non-Binary |
FAQs - About Therapy and Counseling
How can I find a therapist in Winston Salem?
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.