Therapists in Reno, NV
![Photo of Makenzie Ohe, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/86bf8222-3573-4b5e-ba92-15d24f879e16/2/320x400.jpeg)
Life is full of stressors, transitions, past experiences/trauma, and often leads to feelings of anxiety, sadness, stagnation, and frustration. Setting goals and solving problems can feel impossible, and overwhelming to do on ones own. I admire the strength it takes to seek out therapy, and starting one’s journey to healing. I would love the opportunity to assist in your growth. I have experience working with individuals and families who struggle with anxiety, depression, transitions, and trauma; and use non-judgmental, client centered, and strengths-based approaches.
Life is full of stressors, transitions, past experiences/trauma, and often leads to feelings of anxiety, sadness, stagnation, and frustration. Setting goals and solving problems can feel impossible, and overwhelming to do on ones own. I admire the strength it takes to seek out therapy, and starting one’s journey to healing. I would love the opportunity to assist in your growth. I have experience working with individuals and families who struggle with anxiety, depression, transitions, and trauma; and use non-judgmental, client centered, and strengths-based approaches.
![Photo of Skylar Tatu, LPC Intern](https://photos.psychologytoday.com/758e7fb6-5bb1-4e86-b50b-d320029a1f1f/2/320x400.jpeg)
Are you tired of feeling anxious and and not even knowing why you feel that way? You might feel sad and lethargic at other times and lack motivation to do things you used to enjoy. Maybe you know you have a history of trauma and have wondered if there is any way to get back to "normal". I have found that most people have some kind of developmental trauma, if not major traumatic experiences that have left them questioning their value and place in the world. I love working with people who are ready to dig deep to uncover, discover and discard the patterns that are no longer serving them in their lives.
Are you tired of feeling anxious and and not even knowing why you feel that way? You might feel sad and lethargic at other times and lack motivation to do things you used to enjoy. Maybe you know you have a history of trauma and have wondered if there is any way to get back to "normal". I have found that most people have some kind of developmental trauma, if not major traumatic experiences that have left them questioning their value and place in the world. I love working with people who are ready to dig deep to uncover, discover and discard the patterns that are no longer serving them in their lives.
![Photo of Attachment Trauma Therapist Lisa Stoll, LMFT, Marriage & Family Therapist](https://photos.psychologytoday.com/e34e89ff-cd98-4894-8867-7481b4799386/2/320x400.jpeg)
Attachment Trauma Therapist Lisa Stoll
Marriage & Family Therapist, LMFT
Verified Verified
1 Endorsed
Reno, NV 89509
Do you struggle opening up and connecting with the people who matter most? Do you (or your partner) often shut down in conflict or struggle to communicate your needs? Do you feel stuck about where you are in your relationship, but don’t know what to do? If you answered yes to any of these questions, I want you to know that you are capable of having a fulfilling and connected relationship. Hello, my name is Lisa and I am an attachment and trauma therapist. I use EMDR to help you heal from your turbulent or lonely childhoods to create healthier relationships with those who matter most.
Do you struggle opening up and connecting with the people who matter most? Do you (or your partner) often shut down in conflict or struggle to communicate your needs? Do you feel stuck about where you are in your relationship, but don’t know what to do? If you answered yes to any of these questions, I want you to know that you are capable of having a fulfilling and connected relationship. Hello, my name is Lisa and I am an attachment and trauma therapist. I use EMDR to help you heal from your turbulent or lonely childhoods to create healthier relationships with those who matter most.
![Photo of Melody McKibbin, LCPC, C-PD, Counselor](https://photos.psychologytoday.com/7687cdd0-d1ea-460b-8e89-aeb438bef794/1/320x400.jpeg)
Hello! I’m Melody, your guide through the maze of mental health, armed with DBT (Dialectical Behavior Therapy) Level II Accreditation and a flair for making therapy less of a chore and more of a journey. My expertise? BPD (Borderline Personality Disorder). My passion? Turning the tangles of the mind into a clearer path forward. And when I'm not decoding the human psyche, I'm creating tales of murder and comedy where mannequins aren't just window dressing—they're the main suspects. My downtime involves strategizing world domination with my Russian Blue cats and family and friend hangouts.
Hello! I’m Melody, your guide through the maze of mental health, armed with DBT (Dialectical Behavior Therapy) Level II Accreditation and a flair for making therapy less of a chore and more of a journey. My expertise? BPD (Borderline Personality Disorder). My passion? Turning the tangles of the mind into a clearer path forward. And when I'm not decoding the human psyche, I'm creating tales of murder and comedy where mannequins aren't just window dressing—they're the main suspects. My downtime involves strategizing world domination with my Russian Blue cats and family and friend hangouts.
![Photo of Dr. Tennille Warren-Phillips, PsyD, Psychologist](https://photos.psychologytoday.com/fb337a1e-6de2-4ae8-b382-d6233f7d0322/2/320x400.jpeg)
Dr. Tennille Warren-Phillips
Psychologist, PsyD
Verified Verified
1 Endorsed
Reno, NV 89511 (Online Only)
Drowning in a social media wormhole, exploring whether you have a personality disorder? Actively seeking an expert opinion on what is contributing to your distress, emotional instability, fractured relationships, & overall struggle with life? Individuals with personality disorders, like borderline personality disorder, experience distress or impairment from deep seeded patterns of behavior and perspective which clash with society's expectations. This can result in feelings of isolation and have a negative impact on one's life. You want treatment, but where's the experienced providers who specialize in this? That's the hard part.
Drowning in a social media wormhole, exploring whether you have a personality disorder? Actively seeking an expert opinion on what is contributing to your distress, emotional instability, fractured relationships, & overall struggle with life? Individuals with personality disorders, like borderline personality disorder, experience distress or impairment from deep seeded patterns of behavior and perspective which clash with society's expectations. This can result in feelings of isolation and have a negative impact on one's life. You want treatment, but where's the experienced providers who specialize in this? That's the hard part.
![Photo of Lauren Smith, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/240329cb-aac9-4c82-8903-8883688bd768/1/320x400.png)
Are you currently navigating life's transitions, managing stress, or seeking to enhance your relationships? Perhaps you're experiencing mood disorders, anxiety, or struggling with substance use. If you're driven by a desire for personal growth and resilience and are seeking professional support, I'm here to help. If you value a safe and supportive environment where you can explore your concerns, gain clarity, and develop coping skills to thrive in your journey towards emotional well-being, let's connect and discuss how I can assist you.
Are you currently navigating life's transitions, managing stress, or seeking to enhance your relationships? Perhaps you're experiencing mood disorders, anxiety, or struggling with substance use. If you're driven by a desire for personal growth and resilience and are seeking professional support, I'm here to help. If you value a safe and supportive environment where you can explore your concerns, gain clarity, and develop coping skills to thrive in your journey towards emotional well-being, let's connect and discuss how I can assist you.
![Photo of Kamea Sandstrom, MA, LMFT in, Pre-Licensed Professional](https://photos.psychologytoday.com/e7971e6a-016c-4324-aacb-87f034d73476/1/320x400.jpeg)
Kamea is a LMFT Intern who values the client centered approach of counseling with the acknowledgment that clients are the experts of their lives and may need varying approaches. The approaches she has explored range from Narrative and Existential to her current expansion into CBT and DBT.
Kamea is a LMFT Intern who values the client centered approach of counseling with the acknowledgment that clients are the experts of their lives and may need varying approaches. The approaches she has explored range from Narrative and Existential to her current expansion into CBT and DBT.
![Photo of Dr. Tracy S. Kelly - Dr. Tracy S. Kelly, The Strategic Psychotherapist, EdD, LMFT, NCC, Marriage & Family Therapist](https://photos.psychologytoday.com/af7ed6c3-2c2b-480d-86b3-0fbc44920099/2/320x400.jpeg)
Dr. Tracy S. Kelly, The Strategic Psychotherapist
Marriage & Family Therapist, EdD, LMFT, NCC
Verified Verified
Reno, NV 89511
Now accepting new clients! Look forward to a life free from the things that have held you back. I specialize in helping adolescents, adults, couples, and families experience wellness, and healing. If you're seeking new ways to change behaviors, thoughts, and actions, with new tools, you're in the right place. I work with clients to help them heal from a variety of issues including anxiety, depression, low-self esteem, fear, doubt, abuse, grief, loss, ADD/ADHD, infidelity, divorce, blended families, mood disorders, hopelessness, stress, communication, and more.
Now accepting new clients! Look forward to a life free from the things that have held you back. I specialize in helping adolescents, adults, couples, and families experience wellness, and healing. If you're seeking new ways to change behaviors, thoughts, and actions, with new tools, you're in the right place. I work with clients to help them heal from a variety of issues including anxiety, depression, low-self esteem, fear, doubt, abuse, grief, loss, ADD/ADHD, infidelity, divorce, blended families, mood disorders, hopelessness, stress, communication, and more.
![Photo of Katie Hayman, MSW, CSWI, Pre-Licensed Professional](https://photos.psychologytoday.com/864f4023-ab9b-46c7-b595-10975e953dc9/2/320x400.jpeg)
Parenting/guardianship is a job with no instruction manual. Reaching out for help for your child is a brave step. I want to meet you where you are and work together to help your child accept the healthy relationships in their lives and work on skills that can help your child and family. I have extensive experience working with children and adolescents of all backgrounds and experiences. I have worked in both a clinical setting and as a teacher and school counselor. My approach is unique, progressive, and flexible to meet the needs of your child and your family. Accepting New Clients!
Parenting/guardianship is a job with no instruction manual. Reaching out for help for your child is a brave step. I want to meet you where you are and work together to help your child accept the healthy relationships in their lives and work on skills that can help your child and family. I have extensive experience working with children and adolescents of all backgrounds and experiences. I have worked in both a clinical setting and as a teacher and school counselor. My approach is unique, progressive, and flexible to meet the needs of your child and your family. Accepting New Clients!
![Photo of Ami Marsh, LMFT, LCADC, Marriage & Family Therapist](https://photos.psychologytoday.com/0d9bf74a-1ca5-4c3c-bec2-846fc13ad702/3/320x400.jpeg)
Ami Marsh
Marriage & Family Therapist, LMFT, LCADC
Verified Verified
1 Endorsed
Reno, NV 89502
Not accepting new clients
The desire to know why we feel the way we do is instinctive. We want to know how to exist and survive in a world that has broken our connection to others and most importantly ourselves. We want answers. We want to be better. Many of us are in search of a quick fix to cure our heavy hearts. We need direction. We need hope. We need clarity.
The desire to know why we feel the way we do is instinctive. We want to know how to exist and survive in a world that has broken our connection to others and most importantly ourselves. We want answers. We want to be better. Many of us are in search of a quick fix to cure our heavy hearts. We need direction. We need hope. We need clarity.
![Photo of Tarrah Hodges, MFT, Marriage & Family Therapist](https://photos.psychologytoday.com/71124c79-30e1-48ab-b4ef-ab0966be9701/2/320x400.jpeg)
I value the art of listening. I believe life is full of mixed experiences; some being easier to make sense of than others. Humans are fascinatingly complicated and yet simple in some regard. One thing that remains an inevitable fact is the need for growth. Like a root system, our choices, relationships and experiences in life are interconnected and either lead to something beautiful that we can appreciate and admire the hard work or can become a bundle of weeds amidst beautiful things.
I value the art of listening. I believe life is full of mixed experiences; some being easier to make sense of than others. Humans are fascinatingly complicated and yet simple in some regard. One thing that remains an inevitable fact is the need for growth. Like a root system, our choices, relationships and experiences in life are interconnected and either lead to something beautiful that we can appreciate and admire the hard work or can become a bundle of weeds amidst beautiful things.
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![Photo of Heidi Hansen, MSW, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/666712d5-0808-4b47-b451-2c6f2f27d131/1/320x400.jpeg)
I believe that when clients are provided a safe environment, they are freed to work on issues that hold them back from living their best life. My primary focus has been to help clients that are struggling with trauma, depression, and anxiety.
I believe that when clients are provided a safe environment, they are freed to work on issues that hold them back from living their best life. My primary focus has been to help clients that are struggling with trauma, depression, and anxiety.
![Photo of Dr. Gabriela Olavarrieta, PsyD, Psychologist](https://photos.psychologytoday.com/00188bca-fe10-4fd3-a944-35f731796bf6/1/320x400.jpeg)
I provide psychological services for children and adolescents, such as neuropsychological evaluations for neurodevelopmental disorders (i.e., ADHD, Specific Learning Disorders, such as dyslexia) and psychotherapy for trauma, depression, anxiety, behavioral difficulties, and more. I utilize Evidence-Based Practice (EBP) to inform a highly individualized and integrated approach tailored to each child's needs that teaches healthy coping skills (i.e., effective communication skills, relaxation techniques) to replace unhealthy coping skills (i.e., shutting down, screaming) helping them feel in control over their behaviors and feelings.
I provide psychological services for children and adolescents, such as neuropsychological evaluations for neurodevelopmental disorders (i.e., ADHD, Specific Learning Disorders, such as dyslexia) and psychotherapy for trauma, depression, anxiety, behavioral difficulties, and more. I utilize Evidence-Based Practice (EBP) to inform a highly individualized and integrated approach tailored to each child's needs that teaches healthy coping skills (i.e., effective communication skills, relaxation techniques) to replace unhealthy coping skills (i.e., shutting down, screaming) helping them feel in control over their behaviors and feelings.
![Photo of Jim Studer, LMFT, EMDR ,
NCC, Marriage & Family Therapist](https://photos.psychologytoday.com/52bad46a-46cd-11ea-a6ad-06142c356176/3/320x400.jpeg)
I have been working as a Marriage and Family Therapist since September, 2016. I retired from Washoe County School District where I served as a teacher and administrator with students from pre-k through high school. I provide individual, family, and couples counseling in my private practice and I work in Carson City School District providing counseling services for students. My background includes work with individuals on the autism spectrum and their families. I am interested in working with a wide variety of clients including children, adolescents, and adults and hope I can be of assistance to you and your family.
I have been working as a Marriage and Family Therapist since September, 2016. I retired from Washoe County School District where I served as a teacher and administrator with students from pre-k through high school. I provide individual, family, and couples counseling in my private practice and I work in Carson City School District providing counseling services for students. My background includes work with individuals on the autism spectrum and their families. I am interested in working with a wide variety of clients including children, adolescents, and adults and hope I can be of assistance to you and your family.
![Photo of Jackie Jensen, MA, MFT, Marriage & Family Therapist](https://photos.psychologytoday.com/4a12f3d6-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
I work with couples and families who are feeling overwhelmed with stress and dissatisfaction within themselves and with the people they care most about. Improved communication and resolved conflict can restore relationships and enhance overall well-being. Understanding your own needs and taking care of personal struggles can also be a great start.
I work with couples and families who are feeling overwhelmed with stress and dissatisfaction within themselves and with the people they care most about. Improved communication and resolved conflict can restore relationships and enhance overall well-being. Understanding your own needs and taking care of personal struggles can also be a great start.
![Photo of Dr. Krystal S Smith, PsyD, PSYPACT, Psychologist](https://photos.psychologytoday.com/586f4b53-0fe7-4535-a22c-b8454003b2fa/1/320x400.jpeg)
Life can be rough sometimes, and it’s so easy to feel stuck, wondering where you’re headed. My goal is to help you find new perspectives and new ways of looking at any situation so that you can approach life with confidence and authenticity. Along with bringing a multicultural perspective to therapy as a therapist of color, I utilize an integrative approach of Narrative, Interpersonal, and Cognitive Behavioral Therapies, and other modalities that fit your unique life journey.
Life can be rough sometimes, and it’s so easy to feel stuck, wondering where you’re headed. My goal is to help you find new perspectives and new ways of looking at any situation so that you can approach life with confidence and authenticity. Along with bringing a multicultural perspective to therapy as a therapist of color, I utilize an integrative approach of Narrative, Interpersonal, and Cognitive Behavioral Therapies, and other modalities that fit your unique life journey.
![Photo of Vivian McCown, MS, LPC Intern](https://photos.psychologytoday.com/8f38a2fc-7484-4831-9e62-962029ec0941/1/320x400.jpeg)
My goal in counseling clients is to support and walk alongside my clients as they heal, change, grow and become someone they love unconditionally. Counseling is a collaborative process that helps clients gain self-awareness and acceptance. Life is tough and people do not always have the support they need to navigate it. I believe everyone’s voice is important and work hard to provide a safe space for people to have a voice. People are unique in the way they view society, family, relationships, and themselves; so, providing a non-judgmental space for them to be free and gain awareness is something I strive for in counseling clients.
My goal in counseling clients is to support and walk alongside my clients as they heal, change, grow and become someone they love unconditionally. Counseling is a collaborative process that helps clients gain self-awareness and acceptance. Life is tough and people do not always have the support they need to navigate it. I believe everyone’s voice is important and work hard to provide a safe space for people to have a voice. People are unique in the way they view society, family, relationships, and themselves; so, providing a non-judgmental space for them to be free and gain awareness is something I strive for in counseling clients.
![Photo of Helen R Going, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/9e1eb530-bbba-49d1-944f-febf4c967c8b/1/320x400.jpeg)
Relationship difficulties of all kinds can be hard and terribly painful. We get this and we can help. Emotional and Relationship Health Associates are specialists in Emotionally Focused Therapy, which is attachment-based and is well-researched. It is the gold standard in helping relationships. It gets to the root of the problem without judging or taking sides and can bring lasting change that transforms lives and relationships. I love working with couples and individuals to help them improve their lives and function by reaching their personal goals and building strong bonds within their important relationships.
Relationship difficulties of all kinds can be hard and terribly painful. We get this and we can help. Emotional and Relationship Health Associates are specialists in Emotionally Focused Therapy, which is attachment-based and is well-researched. It is the gold standard in helping relationships. It gets to the root of the problem without judging or taking sides and can bring lasting change that transforms lives and relationships. I love working with couples and individuals to help them improve their lives and function by reaching their personal goals and building strong bonds within their important relationships.
![Photo of Jordan Andres, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/909d375a-b960-4893-ac91-1bbaf3b4e9da/4/320x400.jpeg)
I believe one of the most courageous acts is the willingness to explore, accept, and be present for your own life’s journey. I provide a holistic and person-centered approach to help young adults and teens struggling with anxiety, depression, stress, and life adjustments. I provide a genuine and nonjudgmental environment to help make positive change happen in your life.
I believe one of the most courageous acts is the willingness to explore, accept, and be present for your own life’s journey. I provide a holistic and person-centered approach to help young adults and teens struggling with anxiety, depression, stress, and life adjustments. I provide a genuine and nonjudgmental environment to help make positive change happen in your life.
![Photo of Dr. Keasha Walton-Ellis, PsyD, MFT-I, Pre-Licensed Professional](https://photos.psychologytoday.com/2ca70585-6999-4def-bba9-c6260cf04b80/1/320x400.jpeg)
Finding a therapist that you can relate and feel comfortable with may be the most important part of therapy. My goal is to create an environment where you feel safe, supported, and heard, so that you can open up and get the most out of your sessions. I know that starting this process can seem overwhelming. Maybe you're not sure where to begin with all of this. Maybe you're feeling a little anxious. I've been there myself, and I'm here to help.
Finding a therapist that you can relate and feel comfortable with may be the most important part of therapy. My goal is to create an environment where you feel safe, supported, and heard, so that you can open up and get the most out of your sessions. I know that starting this process can seem overwhelming. Maybe you're not sure where to begin with all of this. Maybe you're feeling a little anxious. I've been there myself, and I'm here to help.
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Number of Therapists in Reno, NV
500+
Average cost per session
$150
Therapists in Reno, NV who prioritize treating:
90% | Anxiety |
86% | Depression |
74% | Trauma and PTSD |
74% | Self Esteem |
73% | Relationship Issues |
67% | Stress |
66% | Coping Skills |
Average years in practice
10 Years
Top 3 insurances accepted
71% | Aetna |
62% | BlueCross and BlueShield |
61% | Hometown Health |
How Therapists in Reno, NV see their clients
71% | In Person and Online | |
29% | Online Only |
Gender breakdown
80% | Female | |
19% | Male | |
1% | Non-Binary |
FAQs - About Therapy and Counseling
How can I find a therapist in Reno?
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.