Therapists in Lewiston, NY
![Photo of Kathleen Howey Murphy - Kathleen Howey Murphy, LCSWR, LCSWR, Clinical Social Work/Therapist](https://photos.psychologytoday.com/26fa580a-9688-4900-b373-3cec8524757f/2/320x400.jpeg)
Kathleen Howey Murphy, LCSWR
Clinical Social Work/Therapist, LCSWR
Verified Verified
Lewiston, NY 14092 (Online Only)
"If you correct your mind, the rest of your life will fall into place." (Lao Tzu) Expertise. Experience. Caring. Compassion. Together, we'll create positive changes in your life.
"If you correct your mind, the rest of your life will fall into place." (Lao Tzu) Expertise. Experience. Caring. Compassion. Together, we'll create positive changes in your life.
![Photo of Jamie L Symmonds, LMHC, MA, ME, Counselor](https://photos.psychologytoday.com/1ec1e84e-a568-4355-83b0-dd0ba12539be/1/320x400.jpeg)
My name is Jamie and I work with clients 13 years of age and up. I take a person centered approach and believe in a supportive and honest therapeutic relationship. This includes a therapeutic environment that is non-judgmental and provides unconditional positive regard. I tailor each session based on my clients individual needs, while helping them to improve their daily functioning, in all aspects of life. I utilize an array of therapeutic techniques, tailored to the individual's needs. Specializing in Anxiety, Depression, Mood Disorders, Substance Abuse, Oppositional Defiant Disorder, Life Issues, and Parenting Concerns.
My name is Jamie and I work with clients 13 years of age and up. I take a person centered approach and believe in a supportive and honest therapeutic relationship. This includes a therapeutic environment that is non-judgmental and provides unconditional positive regard. I tailor each session based on my clients individual needs, while helping them to improve their daily functioning, in all aspects of life. I utilize an array of therapeutic techniques, tailored to the individual's needs. Specializing in Anxiety, Depression, Mood Disorders, Substance Abuse, Oppositional Defiant Disorder, Life Issues, and Parenting Concerns.
![Photo of Gina Wills, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/70387441-dccf-4b5c-b659-0ce265e2c531/1/320x400.jpeg)
My name is Gina Wills, and I am a Licensed Clinical Social Worker (LCSW). I have over ten years of experience working with adolescents and adults who are experiencing symptoms of depression, anxiety, and overwhelming stress. I have experience in working with adolescents and adults. During these years we go through many transitions and life can become overwhelming at times. I have successfully worked with clients experiencing anxiety, depression, and additional stress due to various reasons. My goal is to assist clients in establishing skills to help them alleviate their symptoms and restore inner peace.
My name is Gina Wills, and I am a Licensed Clinical Social Worker (LCSW). I have over ten years of experience working with adolescents and adults who are experiencing symptoms of depression, anxiety, and overwhelming stress. I have experience in working with adolescents and adults. During these years we go through many transitions and life can become overwhelming at times. I have successfully worked with clients experiencing anxiety, depression, and additional stress due to various reasons. My goal is to assist clients in establishing skills to help them alleviate their symptoms and restore inner peace.
![Photo of Joy Rock, LMSW](https://photos.psychologytoday.com/2957d242-204c-4840-afcc-1ae072fdd203/2/320x400.jpeg)
Welcome! I offer talk therapy via virtual sessions. Those that I work with are invested in making lasting changes to their emotional health. I work with clients to identify roadblocks and develop a plan for planting small seeds of change. I provide tools and practical solutions to manage daily symptoms. A typical session consists of delving into daily stressors, past challenges as well as coping mechanisms. My clients start to see positive changes to their emotional health within 6 months.
Welcome! I offer talk therapy via virtual sessions. Those that I work with are invested in making lasting changes to their emotional health. I work with clients to identify roadblocks and develop a plan for planting small seeds of change. I provide tools and practical solutions to manage daily symptoms. A typical session consists of delving into daily stressors, past challenges as well as coping mechanisms. My clients start to see positive changes to their emotional health within 6 months.
![Photo of Annie Coburn-Kane, LCSWR, Clinical Social Work/Therapist](https://photos.psychologytoday.com/3fe10e6e-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
Annie Coburn-Kane
Clinical Social Work/Therapist, LCSWR
Verified Verified
2 Endorsed
Lewiston, NY 14092
Experiencing emotional pain and setbacks can lead our minds to limit us due to fear of failure, rejection, or abandonment. As your therapist my approach is supportive, compassionate, and practical. Together, we'll explore your past experiences, understand your symptoms, and develop a plan to help you live better. I utilize a holistic approach integrating various techniques, including EMDR, to personalize your treatment. I'll offer support and guidance as you build on your strengths and achieve personal growth.
Experiencing emotional pain and setbacks can lead our minds to limit us due to fear of failure, rejection, or abandonment. As your therapist my approach is supportive, compassionate, and practical. Together, we'll explore your past experiences, understand your symptoms, and develop a plan to help you live better. I utilize a holistic approach integrating various techniques, including EMDR, to personalize your treatment. I'll offer support and guidance as you build on your strengths and achieve personal growth.
![Photo of Julie Gutowski, LMHC, Counselor](https://photos.psychologytoday.com/2b3cba90-0278-4eb7-9992-811055254056/3/320x400.jpeg)
I work to foster wellness and growth in each individual to allow them to live the life they have chosen as fully as possible. I believe that the individual in counseling is the expert in their life and my role is to help support and guide them to make decisions, make positive changes, increase their coping skills and improve their emotional wellness and quality of life. I have experience working with individuals who have complex needs and challenges and work to utilize their strengths and resources to meet their goals.
I work to foster wellness and growth in each individual to allow them to live the life they have chosen as fully as possible. I believe that the individual in counseling is the expert in their life and my role is to help support and guide them to make decisions, make positive changes, increase their coping skills and improve their emotional wellness and quality of life. I have experience working with individuals who have complex needs and challenges and work to utilize their strengths and resources to meet their goals.
![Photo of Jennifer Weerheim, LMHC, Counselor](https://photos.psychologytoday.com/6e0a2a78-a240-41ba-9a0a-e95c533adba5/2/320x400.jpeg)
Hi, Welcome to my page. It takes courage to seek for a more fulfilling and happier life and to take the first steps towards change. If you are ready to take that step, I am here to support and empower you. We all face challenges in our daily lives. It is helpful to be able to have someone who is experienced to talk to, and who is not emotionally connected to the situation, in order to help you process, find solutions and to obtain goals. This is where I can be a service to you.
Hi, Welcome to my page. It takes courage to seek for a more fulfilling and happier life and to take the first steps towards change. If you are ready to take that step, I am here to support and empower you. We all face challenges in our daily lives. It is helpful to be able to have someone who is experienced to talk to, and who is not emotionally connected to the situation, in order to help you process, find solutions and to obtain goals. This is where I can be a service to you.
![Photo of Anita DePasquale, LMHC, MA, Counselor](https://photos.psychologytoday.com/3c5c7fa7-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
Have you found yourself struggling to deal with the stress of your life circumstances? Are you feeling depressed or anxious? Is your child struggling? If you answered yes to any of these questions, you may find counseling very beneficial. It is at such times, that seeking the help of a professional counselor / therapist is most important.
I believe that each individual has the ability to resolve their struggles and find a place of peace and contentment. I strive to help each of my clients heal, grow and make changes which will promote a happy, healthy and peaceful life.
Have you found yourself struggling to deal with the stress of your life circumstances? Are you feeling depressed or anxious? Is your child struggling? If you answered yes to any of these questions, you may find counseling very beneficial. It is at such times, that seeking the help of a professional counselor / therapist is most important.
I believe that each individual has the ability to resolve their struggles and find a place of peace and contentment. I strive to help each of my clients heal, grow and make changes which will promote a happy, healthy and peaceful life.
![Photo of Nina M Maines, LCSW-R, Clinical Social Work/Therapist](https://photos.psychologytoday.com/4c65f139-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
Nina M Maines
Clinical Social Work/Therapist, LCSW-R
Verified Verified
1 Endorsed
Lewiston, NY 14092
Currently I am only able to accept new clients that can be seen between the hours of 9:00 am- 1 pm. When we talk about our feelings, they become less overwhelming, less upsetting, and less scary. - Fred Rogers
Currently I am only able to accept new clients that can be seen between the hours of 9:00 am- 1 pm. When we talk about our feelings, they become less overwhelming, less upsetting, and less scary. - Fred Rogers
![Photo of Kara Bax, LMSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/3cc1b5d1-33c0-4cc3-98d6-f26d769c39b2/1/320x400.jpeg)
Are you stuck? Does every day feel like you are just trying to get through it? Is your past or current struggle overshadowing every part of your life?
Are you stuck? Does every day feel like you are just trying to get through it? Is your past or current struggle overshadowing every part of your life?
![Photo of Brighid Schuler, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/894f33fe-59fd-42a9-b33b-cd71f9c66c3c/2/320x400.jpeg)
Are you anxious? Struggling with depression? I’m here to help. I utilize CBT, EMDR, and Motivational Interviewing with my clients and have been in practice since 2014. I believe recovery is possible for everyone and getting help is the first step toward changing your life. A little about my philosophy… I believe each person has inherent dignity and worth. One of my missions in practice is to help every client to see this reality within themselves and to restore the broken pieces that were lost along the way.
Are you anxious? Struggling with depression? I’m here to help. I utilize CBT, EMDR, and Motivational Interviewing with my clients and have been in practice since 2014. I believe recovery is possible for everyone and getting help is the first step toward changing your life. A little about my philosophy… I believe each person has inherent dignity and worth. One of my missions in practice is to help every client to see this reality within themselves and to restore the broken pieces that were lost along the way.
More Therapists Nearby
![Photo of Jessica Trucillo, LMHC, Counselor](https://photos.psychologytoday.com/ffd73b5d-7174-4700-b3f8-404c172affc1/1/320x400.jpeg)
Hello! My name is Jessica and I am a psychotherapist here to help you learn more about yourself and live a more fulfilling life via telehealth therapy. I work primarily with young adults, adults and teenagers. I specialize in anxiety and depression, as well as trauma and women's issues. I primarily work with young adults between the ages of 20-35. I have found that this age group suffers from anxiety, depression, and trauma disorders. Likewise, this age group is going through many life transitions that require insight and big decision-making.
Hello! My name is Jessica and I am a psychotherapist here to help you learn more about yourself and live a more fulfilling life via telehealth therapy. I work primarily with young adults, adults and teenagers. I specialize in anxiety and depression, as well as trauma and women's issues. I primarily work with young adults between the ages of 20-35. I have found that this age group suffers from anxiety, depression, and trauma disorders. Likewise, this age group is going through many life transitions that require insight and big decision-making.
![Photo of Yael Sommer, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/416c008f-65ee-4ba6-8b74-886f4015bce3/2/320x400.jpeg)
Hello. My name is Yael Sommer. I am a Licensed Clinical Social Worker with experience spanning over two decades. While I possess experience working with individuals across all age groups, my current practice focuses mostly on adults and couples. My therapeutic approach is integrative, drawing from various theories, such as attachment/relational dynamics, client-centered therapy, strength-based approaches, and cognitive behavioral theory. The specific approach I employ with each client depends on their unique concerns, the duration of their therapeutic engagement, and their desired outcomes.
Hello. My name is Yael Sommer. I am a Licensed Clinical Social Worker with experience spanning over two decades. While I possess experience working with individuals across all age groups, my current practice focuses mostly on adults and couples. My therapeutic approach is integrative, drawing from various theories, such as attachment/relational dynamics, client-centered therapy, strength-based approaches, and cognitive behavioral theory. The specific approach I employ with each client depends on their unique concerns, the duration of their therapeutic engagement, and their desired outcomes.
![Photo of Richard Hoffman - Christian Counseling Associates Of Western Ny](https://photos.psychologytoday.com/b1c7da1c-4a6f-478f-b240-d432d2184f93/1/320x400.jpeg)
Christian Counseling Associates Of Western Ny
Mental Health Counselor
Verified Verified
Niagara Falls, NY 14304
Christian Counseling Associates (CCA) provides individual, marriage, and family counseling. We serve Christians who want their faith integrated into the counseling process and those holding any beliefs or attitudes toward spirituality. Our counselors will help you identify the core issues that have caused your emotional and personal problems and immediately develop strategies to resolve these issues. CCA is able to provide a full range of clinical services. Please visit our website for a complete description of our faith based counseling services, locations, and counseling staff.
Christian Counseling Associates (CCA) provides individual, marriage, and family counseling. We serve Christians who want their faith integrated into the counseling process and those holding any beliefs or attitudes toward spirituality. Our counselors will help you identify the core issues that have caused your emotional and personal problems and immediately develop strategies to resolve these issues. CCA is able to provide a full range of clinical services. Please visit our website for a complete description of our faith based counseling services, locations, and counseling staff.
![Photo of Assata Terry, LMHC, Counselor](https://photos.psychologytoday.com/eee76964-dba3-4596-9e25-29910eaf8e35/2/320x400.jpeg)
Assata Terry is a New York State Licensed Mental Health Counselor. Assata uses Cognitive Behavioral Therapy principles and strategies, person-centered therapy, and additional therapeutic interventions to encourage personal growth and self-expression. Assata uses an Integrative approach, with a foundation in Cognitive Behavioral Therapy (CBT) and a holistic perspective, to guide individuals while they explore issues, gain perspective, learn effective coping skills, and create solutions that bring relief.
Assata Terry is a New York State Licensed Mental Health Counselor. Assata uses Cognitive Behavioral Therapy principles and strategies, person-centered therapy, and additional therapeutic interventions to encourage personal growth and self-expression. Assata uses an Integrative approach, with a foundation in Cognitive Behavioral Therapy (CBT) and a holistic perspective, to guide individuals while they explore issues, gain perspective, learn effective coping skills, and create solutions that bring relief.
![Photo of Jolynn Feagin, LCSW-R, Clinical Social Work/Therapist](https://photos.psychologytoday.com/3f70e5e3-46cd-11ea-a6ad-06142c356176/3/320x400.jpeg)
I understand the importance of integrating not only evidenced based interventions, but also compassion into the counseling relationship. I am an experienced clinical therapist with almost ten years of experience. My career began in substance abuse and then transitioned into serving individuals with mental health challenges. I use a number of strategies to help individuals achieve their goal with a few tactics as examining how perceptions impact problem behaviors, exploring how childhood events impact current functioning & coping as an adult and working to develop tools for improvement of emotional regulation. I also provide Christian counseling to those who are interested.
I understand the importance of integrating not only evidenced based interventions, but also compassion into the counseling relationship. I am an experienced clinical therapist with almost ten years of experience. My career began in substance abuse and then transitioned into serving individuals with mental health challenges. I use a number of strategies to help individuals achieve their goal with a few tactics as examining how perceptions impact problem behaviors, exploring how childhood events impact current functioning & coping as an adult and working to develop tools for improvement of emotional regulation. I also provide Christian counseling to those who are interested.
![Photo of Tantenisha James, LMHC, Counselor](https://photos.psychologytoday.com/b7686078-3d23-44a2-b23c-e35758fcc103/1/320x400.jpeg)
I graduated from Pace University with my Master's Degree as a Licensed Mental Health Therapist and Substance Abuse Counselor. I do not believe in a one-size-fits-all approach to therapy as each individual has specific treatment needs as each person's experiences and the emotional impact of those experiences are unique to that individual. This is why my theoretical approach is humanistic and client-centered. I use Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, Solution Focused Therapy, Motivational Interviewing, Adler, and Gestalt.
I graduated from Pace University with my Master's Degree as a Licensed Mental Health Therapist and Substance Abuse Counselor. I do not believe in a one-size-fits-all approach to therapy as each individual has specific treatment needs as each person's experiences and the emotional impact of those experiences are unique to that individual. This is why my theoretical approach is humanistic and client-centered. I use Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, Solution Focused Therapy, Motivational Interviewing, Adler, and Gestalt.
![Photo of Richard Hoffman - Christian Counseling Associates of Western NY](https://photos.psychologytoday.com/6cc2dec8-ebf3-45c7-bf1e-4cd259b1dcb1/2/320x400.jpeg)
Christian Counseling Associates of Western NY
Licensed Mental Health Counselor
Verified Verified
Niagara Falls, NY 14304
Christian Counseling Associates (CCA) provides individual, marriage, and family counseling. We serve Christians who want their faith integrated into the counseling process and those holding any beliefs or attitudes toward spirituality. Our counselors will help you identify the core issues that have caused your emotional and personal problems, and immediately develop strategies to resolve these issues. CCA is able to provide a full range of clinical services. Please visit our website for a complete description of our faith based counseling services, locations, and counseling staff.
Christian Counseling Associates (CCA) provides individual, marriage, and family counseling. We serve Christians who want their faith integrated into the counseling process and those holding any beliefs or attitudes toward spirituality. Our counselors will help you identify the core issues that have caused your emotional and personal problems, and immediately develop strategies to resolve these issues. CCA is able to provide a full range of clinical services. Please visit our website for a complete description of our faith based counseling services, locations, and counseling staff.
![Photo of Suzanne L Moxham, LCSW-R, Clinical Social Work/Therapist](https://photos.psychologytoday.com/1096396f-3c2b-43a8-8ba2-301a0297d4ba/3/320x400.jpeg)
We sometimes find ourselves struggling with major life changes, day-to-day stressors, and physical health issues. These can lead to depression, anxiety, panic, and/or other negative feelings that can be overwhelming and cause disruption in day-to-day functioning and in relationships. Sometimes, these situations and feelings can even trigger traumas from the past, which can lead to further dysfunction. It can be a tough decision to take the step to call a therapist, but it can also be the first step towards taking back your life.
We sometimes find ourselves struggling with major life changes, day-to-day stressors, and physical health issues. These can lead to depression, anxiety, panic, and/or other negative feelings that can be overwhelming and cause disruption in day-to-day functioning and in relationships. Sometimes, these situations and feelings can even trigger traumas from the past, which can lead to further dysfunction. It can be a tough decision to take the step to call a therapist, but it can also be the first step towards taking back your life.
![Photo of Anna E Shurmatz - Shurmatz Counseling LCSW PC, LCSWR](https://photos.psychologytoday.com/d2bf92f9-bf87-45cc-bfb8-1817c03bf559/1/320x400.jpeg)
You haven’t felt good for months. You can’t get out of your head and your thoughts are constantly racing. Your feelings are in the driver’s seat of your life instead of you. You feel like no one understands, and you’re all alone. All you want to do is change this! Yet you feel so restless, you can't be still or concentrate on one thing for very long. We want to offer you hope that it doesn't have to stay this way. It’s possible to feel whole and alive again. Your nightmares don’t have to haunt you into the day. You can have peace and connection, with yourself and with others. Your joy and energy for life aren’t gone forever.
You haven’t felt good for months. You can’t get out of your head and your thoughts are constantly racing. Your feelings are in the driver’s seat of your life instead of you. You feel like no one understands, and you’re all alone. All you want to do is change this! Yet you feel so restless, you can't be still or concentrate on one thing for very long. We want to offer you hope that it doesn't have to stay this way. It’s possible to feel whole and alive again. Your nightmares don’t have to haunt you into the day. You can have peace and connection, with yourself and with others. Your joy and energy for life aren’t gone forever.
See more therapy options for Lewiston
How does your Therapist compare?
Number of Therapists in Lewiston, NY
10+
Average cost per session
$115
Therapists in Lewiston, NY who prioritize treating:
100% | Anxiety |
91% | Relationship Issues |
91% | Depression |
82% | Grief |
82% | Trauma and PTSD |
82% | Behavioral Issues |
82% | Coping Skills |
Average years in practice
23 Years
Top 3 insurances accepted
80% | Independent Health |
70% | Fidelis |
60% | BlueCross and BlueShield |
How Therapists in Lewiston, NY see their clients
82% | In Person and Online | |
18% | Online Only |
Gender breakdown
100% | Female |
FAQs - About Therapy and Counseling
How can I find a therapist in Lewiston?
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.