Therapists in Grahamsville, NY

Photo of Anastasiya Vladychack, LMHC, Counselor
Anastasiya Vladychack
Counselor, LMHC
Verified Verified
Grahamsville, NY 12740
Hello! I am a Licensed Mental Health Counselor who specializes in adults who are struggling with anxiety, depression, life transitions, personal growth, self esteem, and relationships. I also specialize in working with individuals in the LGBTQIA+ community. It is very important to me that my clients feel safe, understood, and heard, thus the modality of the sessions will be based on what the client is struggling with. I try to incorporate holistic therapy into the sessions as mind, body, and soul work together to gain proper balance in all aspects of life.
Hello! I am a Licensed Mental Health Counselor who specializes in adults who are struggling with anxiety, depression, life transitions, personal growth, self esteem, and relationships. I also specialize in working with individuals in the LGBTQIA+ community. It is very important to me that my clients feel safe, understood, and heard, thus the modality of the sessions will be based on what the client is struggling with. I try to incorporate holistic therapy into the sessions as mind, body, and soul work together to gain proper balance in all aspects of life.
(929) 470-3157 View (929) 470-3157

More Therapists Nearby

Photo of Debra Franklin, LCSW, Clinical Social Work/Therapist
Debra Franklin
Clinical Social Work/Therapist, LCSW
Verified Verified
Ellenville, NY 12428  (Online Only)
After 33 years of experience with adults, children, families, and couples, and many transformational groups, I developed Heart Path Therapy® (HPT), integrating the most life changing tools. They include ancient spiritual wisdom, guided imagery, inner childwork, energy psychology (similar to EFT & EMDR), use of sound, and ancestral connection work (Family Constellations). The goal is to transform emotional and relational struggles by bringing compassion to the source and in turn empower a greater sense of meaning and purpose in life. Join an adolescent or adult HPT® GROUP, inspiring online heart opening communities.
After 33 years of experience with adults, children, families, and couples, and many transformational groups, I developed Heart Path Therapy® (HPT), integrating the most life changing tools. They include ancient spiritual wisdom, guided imagery, inner childwork, energy psychology (similar to EFT & EMDR), use of sound, and ancestral connection work (Family Constellations). The goal is to transform emotional and relational struggles by bringing compassion to the source and in turn empower a greater sense of meaning and purpose in life. Join an adolescent or adult HPT® GROUP, inspiring online heart opening communities.
(860) 308-1071 View (860) 308-1071

Online Therapists

Photo of Paul C. Lounsbury, MA, LMFT, Marriage & Family Therapist
Paul C. Lounsbury
Marriage & Family Therapist, MA, LMFT
Verified Verified
New York, NY 10023  (Online Only)
As you read my profile and wonder whether or not I'm a therapist you'll find easy to relate to and one who can help you accomplish what you want to achieve, perhaps you can also wonder how ready you might be to do what it takes to accomplish the changes you want to make. If you sincerely wish to solve a problem, connect more spontaneously and meaningfully with others (as well as with yourself) and/or bring about a fuller more satisfying use and embodiment of your innate capabilities, I can help you accomplish that transformation - sooner rather than later.
As you read my profile and wonder whether or not I'm a therapist you'll find easy to relate to and one who can help you accomplish what you want to achieve, perhaps you can also wonder how ready you might be to do what it takes to accomplish the changes you want to make. If you sincerely wish to solve a problem, connect more spontaneously and meaningfully with others (as well as with yourself) and/or bring about a fuller more satisfying use and embodiment of your innate capabilities, I can help you accomplish that transformation - sooner rather than later.
(203) 347-4217 View (203) 347-4217
Photo of Brenda Cemelli, LMHC , CASAC, LPC, Counselor
Brenda Cemelli
Counselor, LMHC , CASAC, LPC
Verified Verified
1 Endorsed
Wallkill, NY 12589
Therapy is the use of relationship, story sharing and excavation of the answers you already have within you. Through Active Listening and Reflection, I can assist you in creating strategies to handle life challenges and reinforce your coping skills. I provide accountability for the changes you state you want to make. Your goals and your inner guidance are the sign posts for the trip. My background includes Narrative Therapy, CBT, DBT, Motivational Interviewing, Mindfulness Training and Psychodrama.  I am a cisgender female myself (she/her) and I strive to be an ally to the LGBTQ+ community.
Therapy is the use of relationship, story sharing and excavation of the answers you already have within you. Through Active Listening and Reflection, I can assist you in creating strategies to handle life challenges and reinforce your coping skills. I provide accountability for the changes you state you want to make. Your goals and your inner guidance are the sign posts for the trip. My background includes Narrative Therapy, CBT, DBT, Motivational Interviewing, Mindfulness Training and Psychodrama.  I am a cisgender female myself (she/her) and I strive to be an ally to the LGBTQ+ community.
(845) 237-3884 View (845) 237-3884
Photo of Maryann R Manchester, MSLMFT, Marriage & Family Therapist
Maryann R Manchester
Marriage & Family Therapist, MSLMFT
Verified Verified
Hastings on Hudson, NY 10706
"We can talk it out". I do believe in the talking cure. Once you've shared your problem with me the burden will not be all on you. Life is not easy but having healthy relationships make it all worthwhile. Feeling alone is overwhelming and not necessary when you can get support from your therapist. Let me help you feel better about yourself. Once you feel stronger you will be more confident in your relationships. You cannot change anyone but yourself. I can help you make changes in life that will promote satisfying changes in your relationships
"We can talk it out". I do believe in the talking cure. Once you've shared your problem with me the burden will not be all on you. Life is not easy but having healthy relationships make it all worthwhile. Feeling alone is overwhelming and not necessary when you can get support from your therapist. Let me help you feel better about yourself. Once you feel stronger you will be more confident in your relationships. You cannot change anyone but yourself. I can help you make changes in life that will promote satisfying changes in your relationships
(914) 380-3993 View (914) 380-3993
Photo of Pattianne Reilly, LMSW, Clinical Social Work/Therapist
Pattianne Reilly
Clinical Social Work/Therapist, LMSW
Verified Verified
Glen Cove, NY 11542
I am a holistic and compassionate therapist who wants to help you experience self-acceptance, growth, and well-being. I believe breaking free from negative patterns is possible by learning new coping skills at any point in life. Together, we will foster a relationship that supports you in recognizing and changing negative patterns to better develop your unique qualities and talents. You don't have to do this alone; let's uncover what may be holding you back. I want you to feel seen, heard, and appreciated for your authentic self, who you are inside and out, and allow this to radiate into the life you have or want to create.
I am a holistic and compassionate therapist who wants to help you experience self-acceptance, growth, and well-being. I believe breaking free from negative patterns is possible by learning new coping skills at any point in life. Together, we will foster a relationship that supports you in recognizing and changing negative patterns to better develop your unique qualities and talents. You don't have to do this alone; let's uncover what may be holding you back. I want you to feel seen, heard, and appreciated for your authentic self, who you are inside and out, and allow this to radiate into the life you have or want to create.
(516) 202-4884 View (516) 202-4884
Photo of Ron Murphy, PhD, Psychologist
Ron Murphy
Psychologist, PhD
Verified Verified
New York, NY 10028
I really enjoy working with people who want to be helped with painful feelings and experiences that have interfered with their sense of well being. All of us are limited by upsettingly negative emotions that make it harder to accomplish things that would make our lives richer, more comfortable and secure. I base my work on the principles of Mindfulnes Based Cognitive Behavior Therapy. This approach has been shown to be very successful helping anxiety, depression, post-traumatic stress, phobias and many other individual and relationship issues. Like most experienced therapists, I also integrate ideas from other approaches whenever appropriate.
I really enjoy working with people who want to be helped with painful feelings and experiences that have interfered with their sense of well being. All of us are limited by upsettingly negative emotions that make it harder to accomplish things that would make our lives richer, more comfortable and secure. I base my work on the principles of Mindfulnes Based Cognitive Behavior Therapy. This approach has been shown to be very successful helping anxiety, depression, post-traumatic stress, phobias and many other individual and relationship issues. Like most experienced therapists, I also integrate ideas from other approaches whenever appropriate.
(212) 288-4660 View (212) 288-4660
Photo of Abby Frank, LCSW, LCSW-C, Clinical Social Work/Therapist
Abby Frank
Clinical Social Work/Therapist, LCSW, LCSW-C
Verified Verified
1 Endorsed
New York, NY 10013
Are you struggling with the impact of a chronic illness in your 20s, 30s or beyond? Do you find your thoughts are taken over by anxiety about flare ups, uncertainty about what the future holds? As a licensed clinical social worker, I will work alongside you to address areas in your life that have been causing distress. I value warmth and humor in my relationship with every person I work with and I know what it's like to feel stuck, sick, and consumed by anxiety. I will work with you to create a trusting environment where you can feel safe to be vulnerable at your own pace, and celebrate alongside you in your successes.
Are you struggling with the impact of a chronic illness in your 20s, 30s or beyond? Do you find your thoughts are taken over by anxiety about flare ups, uncertainty about what the future holds? As a licensed clinical social worker, I will work alongside you to address areas in your life that have been causing distress. I value warmth and humor in my relationship with every person I work with and I know what it's like to feel stuck, sick, and consumed by anxiety. I will work with you to create a trusting environment where you can feel safe to be vulnerable at your own pace, and celebrate alongside you in your successes.
(347) 418-0955 View (347) 418-0955
Photo of Dina Macaluso, LCSW, Clinical Social Work/Therapist
Dina Macaluso
Clinical Social Work/Therapist, LCSW
Verified Verified
Plainview, NY 11803
My approach to treatment is to focus on the person and where they are currently struggling. It is important for everyone to have an outlet and a way to engage in daily self care and coping skills. Recognizing triggers and building boundaries are essential for our wellness. I understand that deciding to come to therapy is a huge decision and a choice that is not always easy.
My approach to treatment is to focus on the person and where they are currently struggling. It is important for everyone to have an outlet and a way to engage in daily self care and coping skills. Recognizing triggers and building boundaries are essential for our wellness. I understand that deciding to come to therapy is a huge decision and a choice that is not always easy.
(516) 217-1030 View (516) 217-1030
Photo of Miriam Martinez - Miriam Martinez, PhD Clinical Psychologist, PhD, Psychologist
Miriam Martinez, PhD Clinical Psychologist
Psychologist, PhD
Verified Verified
1 Endorsed
New York, NY 10016
Clients I work with are seeking relief from high levels of stress at home, work, in school, in their relationships, and with parenting. I have 20+ years of experience both in NYC and California working with people who have depression, anxiety and have had traumatic experiences. I apply my expertise in assessment and treatment to help guide the right approach toward achieving your goals. I am an active therapist that is engaged with you helping to keep you motivated and on track.
Clients I work with are seeking relief from high levels of stress at home, work, in school, in their relationships, and with parenting. I have 20+ years of experience both in NYC and California working with people who have depression, anxiety and have had traumatic experiences. I apply my expertise in assessment and treatment to help guide the right approach toward achieving your goals. I am an active therapist that is engaged with you helping to keep you motivated and on track.
(646) 299-9187 View (646) 299-9187
Photo of Elnur Gajiev, PsyD, MA, Psychologist
Elnur Gajiev
Psychologist, PsyD, MA
Verified Verified
New York, NY 10023  (Online Only)
Hi there, I'm Dr. Elnur Gajiev — better known by most as Dr. El. I'm a psychologist, a coach, & a consultant who supports folks in cultivating meaningful lives. In my work, I help my clients align their actions with their values, focusing on building healthy and sustainable habits to navigate stress, overcome overwhelm, and bounce back from burnout. Together, we cultivate practices that empower you to live with greater balance, purpose, and fulfillment.
Hi there, I'm Dr. Elnur Gajiev — better known by most as Dr. El. I'm a psychologist, a coach, & a consultant who supports folks in cultivating meaningful lives. In my work, I help my clients align their actions with their values, focusing on building healthy and sustainable habits to navigate stress, overcome overwhelm, and bounce back from burnout. Together, we cultivate practices that empower you to live with greater balance, purpose, and fulfillment.
(914) 996-4868 View (914) 996-4868
Photo of Risa Levenson, PhD, CH, Psychologist
Risa Levenson
Psychologist, PhD, CH
Verified Verified
Huntington Station, NY 11746
Finding "our calm space" within in a very chaotic world is so important. Life will always throw challenges in our way, how we meet those challenges is very important to who we are as individuals. Find your "calm space". Learn to be your own best friend. Find healthy reciprocal relationships that will be with you for life. Understand that though you are hurting now, you are strong and resilient. There is always some discomfort in positive change. Turn off the social media often. Learn how to be mindful...learn how hypnotherapy (hypnosis + therapy) can change how you feel both physically and emotionally. Look forward!
Finding "our calm space" within in a very chaotic world is so important. Life will always throw challenges in our way, how we meet those challenges is very important to who we are as individuals. Find your "calm space". Learn to be your own best friend. Find healthy reciprocal relationships that will be with you for life. Understand that though you are hurting now, you are strong and resilient. There is always some discomfort in positive change. Turn off the social media often. Learn how to be mindful...learn how hypnotherapy (hypnosis + therapy) can change how you feel both physically and emotionally. Look forward!
(631) 253-8525 View (631) 253-8525
Photo of Shelley Orren-King, LCSW, R, Clinical Social Work/Therapist
Shelley Orren-King
Clinical Social Work/Therapist, LCSW, R
Verified Verified
New York, NY 10016
Do you find your life more challenging than joyful? Has depression and/or anxiety shown up more and more and you are enjoying life less and less? I am a seasoned psychotherapist who can get you back on track and guide you to find the life you want and have dreamed about. For 37 years I have supported many people with problems so challenging, they sometimes wanted to give up….…. Our therapy sessions created a pathway to take their problems and turn them into opportunities. I would like to support you, like them, to find your pathway to live a productive, balanced and joyful life, with family, friends and in your work space.
Do you find your life more challenging than joyful? Has depression and/or anxiety shown up more and more and you are enjoying life less and less? I am a seasoned psychotherapist who can get you back on track and guide you to find the life you want and have dreamed about. For 37 years I have supported many people with problems so challenging, they sometimes wanted to give up….…. Our therapy sessions created a pathway to take their problems and turn them into opportunities. I would like to support you, like them, to find your pathway to live a productive, balanced and joyful life, with family, friends and in your work space.
(516) 715-2596 View (516) 715-2596
Photo of Christina Talleos, LCSW, CASAC-T, Clinical Social Work/Therapist
Christina Talleos
Clinical Social Work/Therapist, LCSW, CASAC-T
Verified Verified
Yonkers, NY 10705  (Online Only)
If life has been overwhelming, you're feeling disconnected from others, struggling with past trauma or addiction, or just need an outside resource to help you; I am here to listen and provide insight and support. In today's world, many things feel uncertain and increasingly difficult, I am here to help you mitigate through your struggles.
If life has been overwhelming, you're feeling disconnected from others, struggling with past trauma or addiction, or just need an outside resource to help you; I am here to listen and provide insight and support. In today's world, many things feel uncertain and increasingly difficult, I am here to help you mitigate through your struggles.
(914) 687-5262 View (914) 687-5262
Photo of Tamar Z Kahane, PsyD, Psychologist
Tamar Z Kahane
Psychologist, PsyD
Verified Verified
New York, NY 10023
Dr. Tamar Z. Kahane, is a highly experienced licensed clinical psychologist with a specialty in children and adolescents. She received her Bachelors from Columbia University and her doctorate from Yeshiva University. She is the founder and clinical director of The Kahane Center, LLC an integrated mental health center providing comprehensive psychological services.
Dr. Tamar Z. Kahane, is a highly experienced licensed clinical psychologist with a specialty in children and adolescents. She received her Bachelors from Columbia University and her doctorate from Yeshiva University. She is the founder and clinical director of The Kahane Center, LLC an integrated mental health center providing comprehensive psychological services.
(201) 254-0556 View (201) 254-0556
Photo of Libby Hartle-Tyrrell, LCSW, Clinical Social Work/Therapist
Libby Hartle-Tyrrell
Clinical Social Work/Therapist, LCSW
Verified Verified
New York, NY 10016
Many people start therapy during a life transition and may be struggling with difficult feelings that accompany these shifts. Others begin therapy because they feel stuck and frustrated with a lack of change. Whatever your impetus, my goal is to create a safe and accepting space in which you can explore the stories that have made up your life- those that reflect your strengths and resilience as well as those that have been accomplices to your suffering. I see myself as an invested collaborator in the process of your self-discovery and healing, a process that we will tailor to you based on what you want to accomplish.
Many people start therapy during a life transition and may be struggling with difficult feelings that accompany these shifts. Others begin therapy because they feel stuck and frustrated with a lack of change. Whatever your impetus, my goal is to create a safe and accepting space in which you can explore the stories that have made up your life- those that reflect your strengths and resilience as well as those that have been accomplices to your suffering. I see myself as an invested collaborator in the process of your self-discovery and healing, a process that we will tailor to you based on what you want to accomplish.
(347) 410-8860 View (347) 410-8860
Photo of Christopher Oliver - Attentional Mind Mental Health Counseling PLLC, LMHC, BCN, COFC, CFI, Counselor
Attentional Mind Mental Health Counseling PLLC
Counselor, LMHC, BCN, COFC, CFI
Verified Verified
Schoharie, NY 12157  (Online Only)
Understand the clinical utilization of mindfulness concepts by scheduling an appointment with Chris Oliver, LMHC/BCN/COFC/CFI. Learning to harness the power of your attention can lead to dramatic improvements in your psychiatric and psychological health needs. Whether you’re seeking a general reduction in your experience with anxiety and depression, are attempting to treat trauma-based and/or stress disorder reactivity concerns, or are looking for long term psychotherapeutic support, Attentional Mind can help.
Understand the clinical utilization of mindfulness concepts by scheduling an appointment with Chris Oliver, LMHC/BCN/COFC/CFI. Learning to harness the power of your attention can lead to dramatic improvements in your psychiatric and psychological health needs. Whether you’re seeking a general reduction in your experience with anxiety and depression, are attempting to treat trauma-based and/or stress disorder reactivity concerns, or are looking for long term psychotherapeutic support, Attentional Mind can help.
(518) 278-6223 View (518) 278-6223
Photo of Carolyn Valenzuela - Remote Therapy LCSW, LCSW, Clinical Social Work/Therapist
Remote Therapy LCSW
Clinical Social Work/Therapist, LCSW
Verified Verified
Port Washington, NY 11050  (Online Only)
Carolyn is a licensed clinical therapist in New York with extensive clinical experience since 2016. She excels in creating a safe, empathetic environment for self-connection. Carolyn is deeply committed to helping individuals understand all aspects of themselves and navigate their inner challenges with a focus on healing.
Carolyn is a licensed clinical therapist in New York with extensive clinical experience since 2016. She excels in creating a safe, empathetic environment for self-connection. Carolyn is deeply committed to helping individuals understand all aspects of themselves and navigate their inner challenges with a focus on healing.
(516) 518-9472 View (516) 518-9472
Photo of Altagracia Martinez - AM Counseling Services LCSW PC, LCSW-R, M-CASAC, MAC, Clinical Social Work/Therapist
AM Counseling Services LCSW PC
Clinical Social Work/Therapist, LCSW-R, M-CASAC, MAC
Verified Verified
Woodbury, NY 11797
Through out my experiences with different client populations with unique life challenges I have come to appreciate emotional turmoil and addictive behaviors and to understand where these problems originate. I have learned to appreciate that what the individual needs is a non judgmental environment where he or she can identify the path to a healthy life and hope.
Through out my experiences with different client populations with unique life challenges I have come to appreciate emotional turmoil and addictive behaviors and to understand where these problems originate. I have learned to appreciate that what the individual needs is a non judgmental environment where he or she can identify the path to a healthy life and hope.
(631) 201-4887 View (631) 201-4887
Photo of Matt Maher - Mettle Works Behavioral Services, PhD, LMHC, LBA, BCBA, Counselor
Mettle Works Behavioral Services
Counselor, PhD, LMHC, LBA, BCBA
Verified Verified
2 Endorsed
Kingston, NY 12401  (Online Only)
We have Immediate Daytime Openings - reach out now! For Assessments we have reserved openings - so reach out now, including Bariatric Psychological Evaluations, diagnostic evaluations, Court Ordered DWI evaluations, and short-term assessment work. We are a group practice that is primarily online. Please visit our website to find out more.
We have Immediate Daytime Openings - reach out now! For Assessments we have reserved openings - so reach out now, including Bariatric Psychological Evaluations, diagnostic evaluations, Court Ordered DWI evaluations, and short-term assessment work. We are a group practice that is primarily online. Please visit our website to find out more.
(845) 303-2659 View (845) 303-2659

How does your Therapist compare?

Number of Therapists in Grahamsville, NY

< 10

Therapists in Grahamsville, NY who prioritize treating:

100% Relationship Issues
100% Depression
100% Anxiety
100% Life Coaching
100% Spirituality
100% Trauma and PTSD
100% Anger Management

Average years in practice

6 Years

Top 3 insurances accepted

100% Aetna
100% Cigna and Evernorth
100% Coventry

How Therapists in Grahamsville, NY see their clients

100% In Person and Online

Gender breakdown

100% Female
FAQs - About Therapy and Counseling

How can I find a therapist in Grahamsville?

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.