Therapists in Peru, NY

Kristina Moquin
Counselor, NCC, LMHC , CCTP
Verified Verified
Peru, NY 12972  (Online Only)
Waitlist for new clients
I have been working in the mental health field since 2003 and have been clinically licensed and board certified since 2008. I believe each individual's journey is unique and being a part of the journey is my favorite part about this job. I meet you where you are at and support you in achieving whatever goals you may have.
I have been working in the mental health field since 2003 and have been clinically licensed and board certified since 2008. I believe each individual's journey is unique and being a part of the journey is my favorite part about this job. I meet you where you are at and support you in achieving whatever goals you may have.
(518) 975-3040 View (518) 975-3040
Photo of Kristen Mitchell, LCSW, Clinical Social Work/Therapist
Kristen Mitchell
Clinical Social Work/Therapist, LCSW
Verified Verified
Peru, NY 12972
Making the step toward change can be very difficult. Beginning therapy can be intimidating but it is a courageous act. My name is Kristen Mitchell, I'm a Licensed Clinical Social Worker. I am here to support you in your journey of becoming your best self.
Making the step toward change can be very difficult. Beginning therapy can be intimidating but it is a courageous act. My name is Kristen Mitchell, I'm a Licensed Clinical Social Worker. I am here to support you in your journey of becoming your best self.
(518) 963-6659 View (518) 963-6659
Photo of Ken Bezio, LMHC , EMDR, Counselor
Ken Bezio
Counselor, LMHC , EMDR
Verified Verified
Peru, NY 12972
Hello, my name is Ken Bezio and We will start seeing patients on 9/2/2024. I was born and raised in the North Country. I am a New York State Licensed Mental Health Counselor (LMHC). Throughout my career I have had the privilege to consult and collaboratively work with health professionals and behavioral organizations for many years within the North Country including but not limited to school settings. I have an array of experience treating individuals across the lifespan. I provide an array of psychoanalytical theoretical approaches including but not limited to EMDR as a means of resolving past trauma to enhance mental wellbeing.
Hello, my name is Ken Bezio and We will start seeing patients on 9/2/2024. I was born and raised in the North Country. I am a New York State Licensed Mental Health Counselor (LMHC). Throughout my career I have had the privilege to consult and collaboratively work with health professionals and behavioral organizations for many years within the North Country including but not limited to school settings. I have an array of experience treating individuals across the lifespan. I provide an array of psychoanalytical theoretical approaches including but not limited to EMDR as a means of resolving past trauma to enhance mental wellbeing.
(518) 500-4127 View (518) 500-4127
Photo of Frances M. Ryan, MS, LMHC, Counselor
Frances M. Ryan
Counselor, MS, LMHC
Verified Verified
Peru, NY 12972
Welcome! In my therapy practice I provide a comfortable, safe and confidential space for my clients to get support, learn, heal and grow. It is my experience that the best environment for emotional healing and individual growth is an environment where the individual feels a high level of trust and support. My goal is to provide that environment to each and every unique person who I see in my practice. I am experienced in treating panic, anxiety, depression, trauma/PTSD, mood disorders, ADHD, self-esteem issues, LBGTQ related concerns, as well as family/relationship issues.
Welcome! In my therapy practice I provide a comfortable, safe and confidential space for my clients to get support, learn, heal and grow. It is my experience that the best environment for emotional healing and individual growth is an environment where the individual feels a high level of trust and support. My goal is to provide that environment to each and every unique person who I see in my practice. I am experienced in treating panic, anxiety, depression, trauma/PTSD, mood disorders, ADHD, self-esteem issues, LBGTQ related concerns, as well as family/relationship issues.
(518) 213-3746 View (518) 213-3746
Photo of Lisa Bellamy, LMHC, Counselor
Lisa Bellamy
Counselor, LMHC
Verified Verified
1 Endorsed
Peru, NY 12972
I am a New York State Licensed Mental Health Therapist with a background in trauma and teen violence. I am passionate about working with clients experiencing anxiety, depression, stress, and life-transitions in a collaborative way to help to move them towards self-betterment. I tend to integrate techniques from cognitive behavioral therapy, mindfulness based cognitive behavioral therapy, person-centered therapy, solution-focused therapy, and strength-based therapy based on client needs. I collaborate with my clients to identify plans and treatment goals to ensure that their true desires are being met throughout therapy.
I am a New York State Licensed Mental Health Therapist with a background in trauma and teen violence. I am passionate about working with clients experiencing anxiety, depression, stress, and life-transitions in a collaborative way to help to move them towards self-betterment. I tend to integrate techniques from cognitive behavioral therapy, mindfulness based cognitive behavioral therapy, person-centered therapy, solution-focused therapy, and strength-based therapy based on client needs. I collaborate with my clients to identify plans and treatment goals to ensure that their true desires are being met throughout therapy.
(518) 896-7607 View (518) 896-7607
Photo of Wayne Ross, LCMHC, Counselor
Wayne Ross
Counselor, LCMHC
Verified Verified
Peru, NY 12972  (Online Only)
Safety and understanding are my promises to you. It is my belief that we live in a traumatizing world, resulting in pervasive disconnection, self-loathing, and loneliness. If you are experiencing some of this, you have come to the right place. My name is Wayne Ross, and I am a Licensed Mental Health Counselor in NY State. My expertise and gifts lie in guiding you toward acceptance and compassion with all parts of yourself. Using a trauma-informed approach, including a strong focus on mindfulness, we will gently yet fiercely explore the aspects of your thoughts and behaviors that no longer serve your vision of life.
Safety and understanding are my promises to you. It is my belief that we live in a traumatizing world, resulting in pervasive disconnection, self-loathing, and loneliness. If you are experiencing some of this, you have come to the right place. My name is Wayne Ross, and I am a Licensed Mental Health Counselor in NY State. My expertise and gifts lie in guiding you toward acceptance and compassion with all parts of yourself. Using a trauma-informed approach, including a strong focus on mindfulness, we will gently yet fiercely explore the aspects of your thoughts and behaviors that no longer serve your vision of life.
(646) 916-5596 View (646) 916-5596
Photo of Ann Marie Csorny, LCSW-R, Clinical Social Work/Therapist
Ann Marie Csorny
Clinical Social Work/Therapist, LCSW-R
Verified Verified
Peru, NY 12972
Thank you for checking out my profile, choosing a therapist is a big decision, as is taking the first step to make that call. I am accepting new clients, in person or remote based on your preference and comfortability. Therapy is a journey we take together, working from a strength based practice to foster emotional growth and well being. We work together to identify and prioritize issues that are negatively impacting your well being & happiness. Through ongoing counseling we address issues, identify and encourage more effective alternatives. Be well.
Thank you for checking out my profile, choosing a therapist is a big decision, as is taking the first step to make that call. I am accepting new clients, in person or remote based on your preference and comfortability. Therapy is a journey we take together, working from a strength based practice to foster emotional growth and well being. We work together to identify and prioritize issues that are negatively impacting your well being & happiness. Through ongoing counseling we address issues, identify and encourage more effective alternatives. Be well.
(518) 302-2343 View (518) 302-2343

More Therapists Nearby

Photo of Sacha M Sanger, LMHC, Counselor
Sacha M Sanger
Counselor, LMHC
Verified Verified
Plattsburgh, NY 12903
Not accepting new clients
I have limited availability at this time - no evening or late afternoon openings. Do you find yourself excelling in certain areas of life only to sit down at the end of the day feeling unfulfilled, drained, on edge, or disconnected; like nothing is good enough no matter how hard you try or that you are losing control? Many people I work with are burned out and frustrated wondering why they can't "just get it together, move on, get this under control, relax, or shut off the thoughts." Worry, sadness, and that knot in the pit of your stomach don't have to keep being part of your everyday life.
I have limited availability at this time - no evening or late afternoon openings. Do you find yourself excelling in certain areas of life only to sit down at the end of the day feeling unfulfilled, drained, on edge, or disconnected; like nothing is good enough no matter how hard you try or that you are losing control? Many people I work with are burned out and frustrated wondering why they can't "just get it together, move on, get this under control, relax, or shut off the thoughts." Worry, sadness, and that knot in the pit of your stomach don't have to keep being part of your everyday life.
View
Photo of Dr. Katie Lawliss, PsyD, BCB, Psychologist
Dr. Katie Lawliss
Psychologist, PsyD, BCB
Verified Verified
1 Endorsed
Plattsburgh, NY 12901  (Online Only)
When life is stressful, it can feel like your body and mind are not on the same page. You might do things that don't align with your emotions and thoughts and struggle to understand why. You might notice you are always thinking about the worst outcomes and not able to focus on the present. Maybe you are just sick of feeling sick, tired, or stressed. By processing your past and focusing on the present, you can feel more connected to your authentic self and feel capable of handling whatever life throws at you.
When life is stressful, it can feel like your body and mind are not on the same page. You might do things that don't align with your emotions and thoughts and struggle to understand why. You might notice you are always thinking about the worst outcomes and not able to focus on the present. Maybe you are just sick of feeling sick, tired, or stressed. By processing your past and focusing on the present, you can feel more connected to your authentic self and feel capable of handling whatever life throws at you.
(518) 919-3845 View (518) 919-3845
Photo of Heather Bradley, LCSW, Clinical Social Work/Therapist
Heather Bradley
Clinical Social Work/Therapist, LCSW
Verified Verified
Plattsburgh, NY 12901  (Online Only)
I have been providing therapy for almost a decade and I believe that therapy is driven by YOU. You let me know what you would like to work on and we move forward from there. I use a variety of therapy methods to help personalize your experience. I value providing a safe, judgement free space to process whatever is on your mind. A little about me, I love dogs and mine might pop in during a telehealth session. My availability is mostly evenings for appointments. I work with adults (18+ years old).
I have been providing therapy for almost a decade and I believe that therapy is driven by YOU. You let me know what you would like to work on and we move forward from there. I use a variety of therapy methods to help personalize your experience. I value providing a safe, judgement free space to process whatever is on your mind. A little about me, I love dogs and mine might pop in during a telehealth session. My availability is mostly evenings for appointments. I work with adults (18+ years old).
(607) 536-3015 View (607) 536-3015
Photo of Vicki Dauphinais, LMHC, CASAC, Master, Counselor
Vicki Dauphinais
Counselor, LMHC, CASAC, Master
Verified Verified
1 Endorsed
Plattsburgh, NY 12901
Not accepting new clients
Welcome to Heartmind Health & Wellness! Are you struggling with grief, trauma, or anxiety that feels out of your control? Feeling stuck and helpless and having difficulty dealing with your emotions, racing thoughts, and challenges in your relationships? Distracting yourself, but it's no longer working? With over 15 years of experience in mental health and addiction treatment, I will work with you to navigate difficult emotions and create healthier thoughts, beliefs and behavior patterns. My style is warm, compassionate, and friendly to create a comfortable environment for you to trust me and the process of your healing journey.
Welcome to Heartmind Health & Wellness! Are you struggling with grief, trauma, or anxiety that feels out of your control? Feeling stuck and helpless and having difficulty dealing with your emotions, racing thoughts, and challenges in your relationships? Distracting yourself, but it's no longer working? With over 15 years of experience in mental health and addiction treatment, I will work with you to navigate difficult emotions and create healthier thoughts, beliefs and behavior patterns. My style is warm, compassionate, and friendly to create a comfortable environment for you to trust me and the process of your healing journey.
View
Photo of Audrey Terkelsen, MA, LMFT, Marriage & Family Therapist
Audrey Terkelsen
Marriage & Family Therapist, MA, LMFT
Verified Verified
2 Endorsed
Plattsburgh, NY 12903  (Online Only)
The first time looking through Psychology Today profiles can be overwhelming. It can still be overwhelming even if you’ve done it many times. You may already be feeling so stuck, so low, so unmotivated and maybe even be asking yourself the question, “what’s wrong with me?”. If that’s the case, combing through these profiles with so many words can feel like a lot. There is no shame in feeling that way and you are certainly not alone. My hope for you and everyone looking for help is that you can find a space where you feel safe and connected to work on why you are struggling.
The first time looking through Psychology Today profiles can be overwhelming. It can still be overwhelming even if you’ve done it many times. You may already be feeling so stuck, so low, so unmotivated and maybe even be asking yourself the question, “what’s wrong with me?”. If that’s the case, combing through these profiles with so many words can feel like a lot. There is no shame in feeling that way and you are certainly not alone. My hope for you and everyone looking for help is that you can find a space where you feel safe and connected to work on why you are struggling.
(864) 920-3318 View (864) 920-3318
Photo of Yael Sommer, LCSW, Clinical Social Work/Therapist
Yael Sommer
Clinical Social Work/Therapist, LCSW
Verified Verified
Keeseville, NY 12944  (Online Only)
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.
(646) 760-3728 View (646) 760-3728
Photo of Kathleen Foster, LCSW, Clinical Social Work/Therapist
Kathleen Foster
Clinical Social Work/Therapist, LCSW
Verified Verified
Plattsburgh, NY 12901  (Online Only)
I assist clients in finding increased presence, health and centeredness With 14 years experience facilitating therapy, I have learned that perspective and action can have huge impacts on our view of the world
I assist clients in finding increased presence, health and centeredness With 14 years experience facilitating therapy, I have learned that perspective and action can have huge impacts on our view of the world
(518) 261-9362 View (518) 261-9362
Photo of Shanzy Carter-Martinez, LMHC, Counselor
Shanzy Carter-Martinez
Counselor, LMHC
Verified Verified
Plattsburgh, NY 12901  (Online Only)
Welcome! Healing is a process that is unique to each of us. I bring an eclectic approach to therapy in order to help you find the healing path that best fits you and your needs. As a therapist, I believe that the therapeutic relationship is critical to assisting you in being able to create the life you most want. You will find a non-judgmental safe space in which you are welcome as the person you are and the person you hope to be. Are you a veteran looking for a group to process your experiences, work through reintegration, reduce substance use or learn skills to help you in your day to day life? Join our support group.
Welcome! Healing is a process that is unique to each of us. I bring an eclectic approach to therapy in order to help you find the healing path that best fits you and your needs. As a therapist, I believe that the therapeutic relationship is critical to assisting you in being able to create the life you most want. You will find a non-judgmental safe space in which you are welcome as the person you are and the person you hope to be. Are you a veteran looking for a group to process your experiences, work through reintegration, reduce substance use or learn skills to help you in your day to day life? Join our support group.
(929) 416-6913 View (929) 416-6913
Photo of Darin Scot Roy, MHC-LP, Pre-Licensed Professional
Darin Scot Roy
Pre-Licensed Professional, MHC-LP
Verified Verified
Plattsburgh, NY 12901  (Online Only)
As your therapist I will see you as the whole and dynamic person you are. I will help you discover which pieces of your story are authentically your own and which pieces no longer (or never) served you. This journey is one that I am excited to embark upon with you while respecting the fact that you are indeed the expert on your narrative. I will be here for you to discover where the authenticity within your narrative may have been lost, perhaps even without your knowledge. Your needs and goals will be of primary importance as we work together to find solutions for those aspects of your narrative that are causing you distress.
As your therapist I will see you as the whole and dynamic person you are. I will help you discover which pieces of your story are authentically your own and which pieces no longer (or never) served you. This journey is one that I am excited to embark upon with you while respecting the fact that you are indeed the expert on your narrative. I will be here for you to discover where the authenticity within your narrative may have been lost, perhaps even without your knowledge. Your needs and goals will be of primary importance as we work together to find solutions for those aspects of your narrative that are causing you distress.
(518) 252-8104 View (518) 252-8104
Photo of Relani Prudhomme, LCSW, Clinical Social Work/Therapist
Relani Prudhomme
Clinical Social Work/Therapist, LCSW
Verified Verified
2 Endorsed
Plattsburgh, NY 12901  (Online Only)
I am a Queer, neurodivergent, IFS-Informed EMDR psychotherapist who helps people tap into the natural healing power of the brain. If you have tried talk therapy without the success you had hoped for, EMDR and IFS may be for you. Eye Movement Desensitization and Reprocessing (EMDR) and Internal Family Systems (IFS) are safe and effective, non-pathologizing, experiential modalities that help you reprocess past events and heal old wounds at the root, so you can let go of toxic thought patterns and blossom into a life worth living! I help you move beyond coping and to experience lasting healing.
I am a Queer, neurodivergent, IFS-Informed EMDR psychotherapist who helps people tap into the natural healing power of the brain. If you have tried talk therapy without the success you had hoped for, EMDR and IFS may be for you. Eye Movement Desensitization and Reprocessing (EMDR) and Internal Family Systems (IFS) are safe and effective, non-pathologizing, experiential modalities that help you reprocess past events and heal old wounds at the root, so you can let go of toxic thought patterns and blossom into a life worth living! I help you move beyond coping and to experience lasting healing.
View
Photo of Sheri King, NCC, LMHC, Counselor
Sheri King
Counselor, NCC, LMHC
Verified Verified
Plattsburgh, NY 12901  (Online Only)
I am accepting new clients. Who you are depends upon you. You have the answers within you. I can help you find those answers. I assist individuals work toward healing from within through building a sense of empowerment and self-confidence; to regain power that was taken, not allowed, or discouraged; to walk strongly, confidently, and purposefully toward wants, desires, needs, and goals. I guide couples in developing healthy relationship skills and to improve communication and assist parents in enhancing their communication skills with their children and to improve upon what parents already know about parenting.
I am accepting new clients. Who you are depends upon you. You have the answers within you. I can help you find those answers. I assist individuals work toward healing from within through building a sense of empowerment and self-confidence; to regain power that was taken, not allowed, or discouraged; to walk strongly, confidently, and purposefully toward wants, desires, needs, and goals. I guide couples in developing healthy relationship skills and to improve communication and assist parents in enhancing their communication skills with their children and to improve upon what parents already know about parenting.
(518) 302-4391 View (518) 302-4391
Photo of Kim Fisher, NCC, LMHC, Counselor
Kim Fisher
Counselor, NCC, LMHC
Verified Verified
Plattsburgh, NY 12901
My practice is currently at capacity. If space opens up I will change my status on PT as soon as I can. In addition to CBT, DBT, EMDR, and exploratory and supportive therapy I am now offering RTM (Reconsolidation of Traumatic Memories) and am currently working on certification for this very effective new modality.
My practice is currently at capacity. If space opens up I will change my status on PT as soon as I can. In addition to CBT, DBT, EMDR, and exploratory and supportive therapy I am now offering RTM (Reconsolidation of Traumatic Memories) and am currently working on certification for this very effective new modality.
(518) 217-4189 View (518) 217-4189
Photo of Maria Cronyn, ND
Maria Cronyn
ND
Verified Verified
Plattsburgh, NY 12901
Specializing in fining the root cause of mental health problems. Comb through together to find any biological reason such as Lyme or hormone imbalance. Hormone health IS mental health! Testing and treatment with choices of natural or pharmaceutical. Medication side effects? Natural solutions to this. Children respond well to homeopathy- non pharmaceutical approach for ADHD, Anxiety, Depression, OCD, Autism, ODD. I am a Naturopathic Physician billing insurances in VT. Homeopathics, nutrients and IV's, and botanicals remedies and bio identical hormone thereapy, includes Thyroid! Let's be a team.
Specializing in fining the root cause of mental health problems. Comb through together to find any biological reason such as Lyme or hormone imbalance. Hormone health IS mental health! Testing and treatment with choices of natural or pharmaceutical. Medication side effects? Natural solutions to this. Children respond well to homeopathy- non pharmaceutical approach for ADHD, Anxiety, Depression, OCD, Autism, ODD. I am a Naturopathic Physician billing insurances in VT. Homeopathics, nutrients and IV's, and botanicals remedies and bio identical hormone thereapy, includes Thyroid! Let's be a team.
(802) 278-6075 View (802) 278-6075

See more therapy options for Peru

How does your Therapist compare?

Number of Therapists in Peru, NY

< 10

Therapists in Peru, NY who prioritize treating:

86% Anxiety
71% Relationship Issues
71% Depression
71% Trauma and PTSD
71% Family Conflict
71% Coping Skills
71% Self Esteem

Average years in practice

12 Years

Top 3 insurances accepted

83% UnitedHealthcare UHC | UBH
83% Optum
67% Aetna

How Therapists in Peru, NY see their clients

72% In Person and Online
28% Online Only

Gender breakdown

80% Female
20% Male
FAQs - About Therapy and Counseling

How can I find a therapist in Peru?

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.