Therapists in East Avenue, Rochester, NY

Photo of Max Wallace, PsyD, Psychologist
Max Wallace
Psychologist, PsyD
Verified Verified
East Avenue, Rochester, NY 14607
I am a licensed clinical psychologist specializing in the treatment of young adults and young professionals. I love working with others to find or create their own meaning and identity. Often this requires working on the issues that get in the way, like anxiety, depression, grief, or stress. Whether through a desire to change circumstances, improve self-compassion, or develop better relationships with important people, forming or changing your sense of self will be one of the most important experiences of your life.
I am a licensed clinical psychologist specializing in the treatment of young adults and young professionals. I love working with others to find or create their own meaning and identity. Often this requires working on the issues that get in the way, like anxiety, depression, grief, or stress. Whether through a desire to change circumstances, improve self-compassion, or develop better relationships with important people, forming or changing your sense of self will be one of the most important experiences of your life.
(585) 449-0125 View (585) 449-0125
Photo of Bruce D Horowitz, LCSW, Clinical Social Work/Therapist
Bruce D Horowitz
Clinical Social Work/Therapist, LCSW
Verified Verified
East Avenue, Rochester, NY 14607
I am a therapist with over 30 years experience working with clients. I use an informal eclectic approach that promotes client comfort and maximizes peoples potential to change. I am currently utilizing Motivational Interviewing techniques. I have extensive experience working with pre-teens, adolescents, young adults and adults. I am expert at working with clients of varied race, ethnicity, gender and varied socio-economic circumstances.
I am a therapist with over 30 years experience working with clients. I use an informal eclectic approach that promotes client comfort and maximizes peoples potential to change. I am currently utilizing Motivational Interviewing techniques. I have extensive experience working with pre-teens, adolescents, young adults and adults. I am expert at working with clients of varied race, ethnicity, gender and varied socio-economic circumstances.
(585) 420-7225 View (585) 420-7225
Photo of Christina Rose Mannion, MA, PsyD, LCP, Psychologist
Christina Rose Mannion
Psychologist, MA, PsyD, LCP
Verified Verified
2 Endorsed
East Avenue, Rochester, NY 14607
Many of my clients find me because they have tried "everything" and nothing seems to work. With long histories of challenging experiences, negative thought patterns, and emotional overload, it can be hard to know where to start. I help clients identify the root causes of their negative emotional states, learn skills to cope with current distress, and assist in processing through past traumas to find a place of healing. Paying equal attention to mind and body, I help bring a sense of calm to both. Not sure if I'm a good fit? Email & we'll chat to find out. I'll provide information and resources if we don't match.
Many of my clients find me because they have tried "everything" and nothing seems to work. With long histories of challenging experiences, negative thought patterns, and emotional overload, it can be hard to know where to start. I help clients identify the root causes of their negative emotional states, learn skills to cope with current distress, and assist in processing through past traumas to find a place of healing. Paying equal attention to mind and body, I help bring a sense of calm to both. Not sure if I'm a good fit? Email & we'll chat to find out. I'll provide information and resources if we don't match.
View
Photo of Relationship And Trauma Therapist Sarah Nunes, NIC, LMSW, Clinical Social Work/Therapist
Relationship And Trauma Therapist Sarah Nunes
Clinical Social Work/Therapist, NIC, LMSW
Verified Verified
8 Endorsed
East Avenue, Rochester, NY 14610  (Online Only)
Do you feel unsatisfied, stuck, or anxious in your relationships? You watch as other people go on to have successful relationships while you feel stuck in repeat. Are you on the verge of divorce? You might be driven in other areas of your life but feel like you can't quite hack it when it comes to relationships. You might have tried a plethora of therapists in the past that don’t connect with you or seem not to understand where you are coming from. You are looking for someone to tell you like it is, understands where you are coming from, and invest in your future success.
Do you feel unsatisfied, stuck, or anxious in your relationships? You watch as other people go on to have successful relationships while you feel stuck in repeat. Are you on the verge of divorce? You might be driven in other areas of your life but feel like you can't quite hack it when it comes to relationships. You might have tried a plethora of therapists in the past that don’t connect with you or seem not to understand where you are coming from. You are looking for someone to tell you like it is, understands where you are coming from, and invest in your future success.
(585) 440-8955 View (585) 440-8955
Photo of Michelle Solomou, LCSW-R, Clinical Social Work/Therapist
Michelle Solomou
Clinical Social Work/Therapist, LCSW-R
Verified Verified
East Avenue, Rochester, NY 14607
I am Licensed Clinical Social Worker who provides counseling to couples and individuals ages 16 and up. I provide a compassionate, non-judgmental space where clients can process thoughts and feelings, identify unhelpful patterns and behaviors and better understand themselves and their internal experience. My approach is warm, empathetic and supportive, building on your strengths.
I am Licensed Clinical Social Worker who provides counseling to couples and individuals ages 16 and up. I provide a compassionate, non-judgmental space where clients can process thoughts and feelings, identify unhelpful patterns and behaviors and better understand themselves and their internal experience. My approach is warm, empathetic and supportive, building on your strengths.
(585) 257-0406 View (585) 257-0406
Photo of Dr. Amanda O'Hearn, PhD, Psychologist
Dr. Amanda O'Hearn
Psychologist, PhD
Verified Verified
East Avenue, Rochester, NY 14607  (Online Only)
Over the past 24 years, I have worked with clients with a range of issues from depression and anxiety to stress and relationship issues. My clients describe me as approachable, down-to-earth and practical in my work with them. I enjoy the process of exploring what is causing distress and identifying together what needs to be done to resolve those issues, whether that be learning more effective ways of responding or working towards acceptance, or a little bit of both. I believe my clients know best what they need and I am there to guide them in that process.
Over the past 24 years, I have worked with clients with a range of issues from depression and anxiety to stress and relationship issues. My clients describe me as approachable, down-to-earth and practical in my work with them. I enjoy the process of exploring what is causing distress and identifying together what needs to be done to resolve those issues, whether that be learning more effective ways of responding or working towards acceptance, or a little bit of both. I believe my clients know best what they need and I am there to guide them in that process.
(585) 572-7047 View (585) 572-7047
Photo of Kristy Bormann - Kristy Bormann, LCSW-R , Clinical Social Work/Therapist
Kristy Bormann
Clinical Social Work/Therapist, LCSW-R
Verified Verified
3 Endorsed
East Avenue, Rochester, NY 14607
Not accepting new clients
Find Freedom Within! Do you need a motivational lift? How about a deep exploration of your situation? I make sure you feel heard and seen, with solutions and considerations that may assist you. I embrace the human experience with open ears! Your culture, personality, and mind will be supported when working with me.
Find Freedom Within! Do you need a motivational lift? How about a deep exploration of your situation? I make sure you feel heard and seen, with solutions and considerations that may assist you. I embrace the human experience with open ears! Your culture, personality, and mind will be supported when working with me.
(585) 257-0879 View (585) 257-0879
Photo of Natalie Neil, LCSW-R, Clinical Social Work/Therapist
Natalie Neil
Clinical Social Work/Therapist, LCSW-R
Verified Verified
East Avenue, Rochester, NY 14607  (Online Only)
I love what I do...helping people to manage more effectively and live the lives they want to! I know how anxiety and depression can impact a persons life, but I also know that people can learn skills to manage better. Maybe you have been in therapy before, and are really looking for skills to do things different? I am very solution focused. If you want to master any aspects of your life, and are invested in moving forward, then I would love to work with you!
I love what I do...helping people to manage more effectively and live the lives they want to! I know how anxiety and depression can impact a persons life, but I also know that people can learn skills to manage better. Maybe you have been in therapy before, and are really looking for skills to do things different? I am very solution focused. If you want to master any aspects of your life, and are invested in moving forward, then I would love to work with you!
(585) 326-8589 View (585) 326-8589
Photo of Meghan Crough, MA, LMFT, Marriage & Family Therapist
Meghan Crough
Marriage & Family Therapist, MA, LMFT
Verified Verified
1 Endorsed
East Avenue, Rochester, NY 14607
Life should be Better than it often is. You know that your life isn't quite where you want it to be. I am committed to helping you achieve high quality answers to your deepest questions. I work with individuals, couples and families to get what you truly want. My therapy is engaging, useful and a powerful support for positive change in your life. Some Testimonials: Just a note to say that you were such a breath of fresh air when I needed it most. I have totally enjoyed talking with you, so affirming and perspective adjusting. Thanks, Meghan! -KW
Life should be Better than it often is. You know that your life isn't quite where you want it to be. I am committed to helping you achieve high quality answers to your deepest questions. I work with individuals, couples and families to get what you truly want. My therapy is engaging, useful and a powerful support for positive change in your life. Some Testimonials: Just a note to say that you were such a breath of fresh air when I needed it most. I have totally enjoyed talking with you, so affirming and perspective adjusting. Thanks, Meghan! -KW
(585) 228-0386 View (585) 228-0386
Photo of Marianne Lane, LCSW, MS, Clinical Social Work/Therapist
Marianne Lane
Clinical Social Work/Therapist, LCSW, MS
Verified Verified
East Avenue, Rochester, NY 14607
Waitlist for new clients
Taking a step today and talking today will help you lead a better tomorrow. Managing daily life can be challenging and when those challenges are compounded by depression, anxiety, grief, or struggles past or present issues, life can become overwhelming. If you recognize this in your life, let me help. You are not alone.
Taking a step today and talking today will help you lead a better tomorrow. Managing daily life can be challenging and when those challenges are compounded by depression, anxiety, grief, or struggles past or present issues, life can become overwhelming. If you recognize this in your life, let me help. You are not alone.
(585) 440-3857 x3 View (585) 440-3857 x3
Photo of Adriana Eylise Rogachefsky, LMFT, Marriage & Family Therapist
Adriana Eylise Rogachefsky
Marriage & Family Therapist, LMFT
Verified Verified
East Avenue, Rochester, NY 14610
Therapy is a process, it is a critical journey of introspection in a supportive way. I truly believe that all of my clients have the "road map" to get to where they want to go. I see myself as a tool to help offer support and guidance. I am committed to providing client centered care and I view you as the expert of your life.
Therapy is a process, it is a critical journey of introspection in a supportive way. I truly believe that all of my clients have the "road map" to get to where they want to go. I see myself as a tool to help offer support and guidance. I am committed to providing client centered care and I view you as the expert of your life.
(585) 763-0114 View (585) 763-0114
Photo of Jillian Morrill, LMHC
Jillian Morrill
Mental Health Counselor, LMHC
Verified Verified
2 Endorsed
East Avenue, Rochester, NY 14607
Not accepting new clients
Do you feel like your past is haunting you? Are you frequently anxious or upset? Do you avoid going certain places because you just don't feel safe? Scary and painful experiences often change people. I want you to know that it isn't your fault, you are not alone, and the damage is not irreparable. You can put the scary and painful parts of your past where they belong, in the past. You can feel better about yourself, have healthier relationships, and be more comfortable when venturing out into the world. There are treatments that have been proven to help. There is hope.
Do you feel like your past is haunting you? Are you frequently anxious or upset? Do you avoid going certain places because you just don't feel safe? Scary and painful experiences often change people. I want you to know that it isn't your fault, you are not alone, and the damage is not irreparable. You can put the scary and painful parts of your past where they belong, in the past. You can feel better about yourself, have healthier relationships, and be more comfortable when venturing out into the world. There are treatments that have been proven to help. There is hope.
(585) 684-8120 View (585) 684-8120
Photo of Shauna Bort, LMSW
Shauna Bort
LMSW
Verified Verified
2 Endorsed
East Avenue, Rochester, NY 14607  (Online Only)
As a therapist, I know that the relationship we form is what leads to client success, no matter what that looks like for you. The relationship and connection that we create during our sessions is what will allow us to identify your goals, and work together to create the meaningful and sustainable change you are looking to accomplish. Whether you are looking to learn how to better manage your everyday stressors and interpersonal issues, or you are looking to work through trauma, depression, or anxiety, I will provide client-centered, empathetic care that allows you to build connection with yourself, others, and the world around you.
As a therapist, I know that the relationship we form is what leads to client success, no matter what that looks like for you. The relationship and connection that we create during our sessions is what will allow us to identify your goals, and work together to create the meaningful and sustainable change you are looking to accomplish. Whether you are looking to learn how to better manage your everyday stressors and interpersonal issues, or you are looking to work through trauma, depression, or anxiety, I will provide client-centered, empathetic care that allows you to build connection with yourself, others, and the world around you.
(585) 673-0106 View (585) 673-0106
Photo of Cheryl A. Bianchi, LCSW-R, ACSW, EAS-C, Clinical Social Work/Therapist
Cheryl A. Bianchi
Clinical Social Work/Therapist, LCSW-R, ACSW, EAS-C
Verified Verified
East Avenue, Rochester, NY 14610
I have been helping individuals, couples and families for over 30 years. Clients & colleagues describe me as experienced, effective, direct, honest, kind, compassionate, genuine & caring. Strengths are my empathy & ability to connect with others in a therapeutic way as to help facilitate growth, change and movement in their lives & acceptance of self. I use an eclectic approach: cognitive-behavioral, experiential, relational, solution-focused, supportive, trauma informed, and insight-oriented psychotherapy. Expertise working with couples, families & adolescents. An Addiction Specialist and an OASAS-DMV Provider for drug & alcohol evaluations, assessment and treatment. I am also certified by EAPA as a Employee Assistance Specialist-Clinical(EAS-C).
I have been helping individuals, couples and families for over 30 years. Clients & colleagues describe me as experienced, effective, direct, honest, kind, compassionate, genuine & caring. Strengths are my empathy & ability to connect with others in a therapeutic way as to help facilitate growth, change and movement in their lives & acceptance of self. I use an eclectic approach: cognitive-behavioral, experiential, relational, solution-focused, supportive, trauma informed, and insight-oriented psychotherapy. Expertise working with couples, families & adolescents. An Addiction Specialist and an OASAS-DMV Provider for drug & alcohol evaluations, assessment and treatment. I am also certified by EAPA as a Employee Assistance Specialist-Clinical(EAS-C).
(585) 492-6195 View (585) 492-6195
Photo of Christopher Karlic, LCSW, Clinical Social Work/Therapist
Christopher Karlic
Clinical Social Work/Therapist, LCSW
Verified Verified
East Avenue, Rochester, NY 14607
Chris received his Master’s Degree in Social Work from New York University. He is an experienced psychotherapist in both inpatient and outpatient settings. His approach to therapy is client-centered and integrates psychodynamic psychotherapy, Bowen family systems therapy, CBT, and mindfulness skills as appropriate, uniquely tailored to each client. He believes that each person is capable of tapping into their strengths to live a life they find meaningful.
Chris received his Master’s Degree in Social Work from New York University. He is an experienced psychotherapist in both inpatient and outpatient settings. His approach to therapy is client-centered and integrates psychodynamic psychotherapy, Bowen family systems therapy, CBT, and mindfulness skills as appropriate, uniquely tailored to each client. He believes that each person is capable of tapping into their strengths to live a life they find meaningful.
(585) 502-9157 View (585) 502-9157
Photo of Lisa van Leeuwen, LMSW, Clinical Social Work/Therapist
Lisa van Leeuwen
Clinical Social Work/Therapist, LMSW
Verified Verified
1 Endorsed
East Avenue, Rochester, NY 14607
Waitlist for new clients
I'm passionate about providing a safe and therapeutic space for those who have experienced childhood, sexual, race or gender based, or combat-related trauma. I'm trained in trauma-informed mental health care and developed my therapeutic approach working with a diverse population of individuals and families. I'm deeply sensitive to racial, cultural, occupational, economic, and social justice-related influences on how we experience and heal from trauma.
I'm passionate about providing a safe and therapeutic space for those who have experienced childhood, sexual, race or gender based, or combat-related trauma. I'm trained in trauma-informed mental health care and developed my therapeutic approach working with a diverse population of individuals and families. I'm deeply sensitive to racial, cultural, occupational, economic, and social justice-related influences on how we experience and heal from trauma.
(585) 636-3195 View (585) 636-3195
Photo of Frank Barone, LCSW-R, MSW, BCD, Clinical Social Work/Therapist
Frank Barone
Clinical Social Work/Therapist, LCSW-R, MSW, BCD
Verified Verified
East Avenue, Rochester, NY 14610  (Online Only)
I am a psychotherapist specializing in growth-oriented counseling with adults & couples. My clients typically work to increase awareness of their present life patterns which lead to various forms of emotional distress. This pain often causes significant disruption in their social, work, physical lives or intimate relationships. Early life experiences influence how we all experience our lives today. Insights and associations during talk therapy often bring previously unseen dynamics to light leading to healthier choices and increased fulfillment. Sessions take place weekly over the course of many months or more for lasting growth.
I am a psychotherapist specializing in growth-oriented counseling with adults & couples. My clients typically work to increase awareness of their present life patterns which lead to various forms of emotional distress. This pain often causes significant disruption in their social, work, physical lives or intimate relationships. Early life experiences influence how we all experience our lives today. Insights and associations during talk therapy often bring previously unseen dynamics to light leading to healthier choices and increased fulfillment. Sessions take place weekly over the course of many months or more for lasting growth.
(585) 271-0350 View (585) 271-0350
Photo of Kerry Spinosa, LMHC, Counselor
Kerry Spinosa
Counselor, LMHC
Verified Verified
1 Endorsed
East Avenue, Rochester, NY 14610
Hello and welcome! I am a Licensed Mental Health Counselor who believes in a person-centered approach to therapy. I see therapy as a process of self-exploration, and my role is to help my clients gain insight into themselves and their ways of being in the world. Using a strength-based approach, clients will feel empowered to make the changes they want to make in their lives. As of June 27, 2023, I am out on maternity leave. I will be returning in November.
Hello and welcome! I am a Licensed Mental Health Counselor who believes in a person-centered approach to therapy. I see therapy as a process of self-exploration, and my role is to help my clients gain insight into themselves and their ways of being in the world. Using a strength-based approach, clients will feel empowered to make the changes they want to make in their lives. As of June 27, 2023, I am out on maternity leave. I will be returning in November.
(585) 460-2156 View (585) 460-2156
Photo of Melissa Joy Annechino, MA, LMHC, Counselor
Melissa Joy Annechino
Counselor, MA, LMHC
Verified Verified
East Avenue, Rochester, NY 14607  (Online Only)
Life can be both beautiful & messy. I'm humbled & honored to help you sort through it! We each uniquely form our conscious & subconscious schemas and belief systems about ourselves, others, and the world at large since our earliest stages in life. No two people have the same experience, and there is no such thing as a "one size fits all" treatment modality. Yet we can also feel validated & gain from others' shared experiences, perspectives, and support. One thing all humans universally experience is the capacity for love, joy, pain, and everything else in between. You are not alone!
Life can be both beautiful & messy. I'm humbled & honored to help you sort through it! We each uniquely form our conscious & subconscious schemas and belief systems about ourselves, others, and the world at large since our earliest stages in life. No two people have the same experience, and there is no such thing as a "one size fits all" treatment modality. Yet we can also feel validated & gain from others' shared experiences, perspectives, and support. One thing all humans universally experience is the capacity for love, joy, pain, and everything else in between. You are not alone!
(585) 308-9856 View (585) 308-9856
Photo of Lorrie Johnson, LCSW, Clinical Social Work/Therapist
Lorrie Johnson
Clinical Social Work/Therapist, LCSW
Verified Verified
2 Endorsed
East Avenue, Rochester, NY 14607
Hello, thank you for visiting, I am so happy that you are taking this first step. If you struggle with the direction your life is going, or your symptoms are keeping you from healthy relationships, work, and living life to the fullest; I want you to know that change is possible. Therapy can help you cultivate the life you want and deserve by implementing validating, compassionate, solution-focused healing. My specialization is in attachment, dissociative disorders and trauma. My interventions are based in neuroscience and research. Brain Spotting, Internal Family Systems, Schema, Shadow work, Cognitive Therapy, DBT, and EMDR.
Hello, thank you for visiting, I am so happy that you are taking this first step. If you struggle with the direction your life is going, or your symptoms are keeping you from healthy relationships, work, and living life to the fullest; I want you to know that change is possible. Therapy can help you cultivate the life you want and deserve by implementing validating, compassionate, solution-focused healing. My specialization is in attachment, dissociative disorders and trauma. My interventions are based in neuroscience and research. Brain Spotting, Internal Family Systems, Schema, Shadow work, Cognitive Therapy, DBT, and EMDR.
(585) 209-5165 View (585) 209-5165
1

See more therapy options for East Avenue, Rochester

How does your Therapist compare?

Number of Therapists in East Avenue, Rochester, NY

30+

Average cost per session

$125

Therapists in East Avenue, Rochester, NY who prioritize treating:

97% Anxiety
91% Relationship Issues
88% Self Esteem
84% Trauma and PTSD
78% Depression
75% Stress
72% Grief

Average years in practice

13 Years

Top 3 insurances accepted

95% Aetna
75% BlueCross and BlueShield
75% Excellus BlueCross BlueShield

How Therapists in East Avenue, Rochester, NY see their clients

69% In Person and Online
31% Online Only

Gender breakdown

79% Female
21% Male
FAQs - About Therapy and Counseling

How can I find a therapist in East Avenue, Rochester?

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.