Therapists in Enola, PA
![Photo of Alexandra Stewart, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/bda1eefa-8d95-44b4-8302-8063e4dd2813/1/320x400.jpeg)
Alexandra Stewart
Clinical Social Work/Therapist, LCSW
Verified Verified
Enola, PA 17025 (Online Only)
Hello! My name is Alexa Stewart. I'm an LCSW located in Pennsylvania. I have been working in this field for around 10 years. The majority of individuals that I work with struggle with issues such as depression, anxiety, relationship conflicts, attachment, trauma and self esteem issues.
Hello! My name is Alexa Stewart. I'm an LCSW located in Pennsylvania. I have been working in this field for around 10 years. The majority of individuals that I work with struggle with issues such as depression, anxiety, relationship conflicts, attachment, trauma and self esteem issues.
![Photo of E. Renea Snyder, MS, MAC, ICAADC, CCTP, CCFAS](https://photos.psychologytoday.com/7f3aa1b6-b45e-4725-b392-6419dbbbb3db/1/320x400.jpeg)
Renea Snyder is focused on evidence based holistic treatment for those afflicted with the disease of addiction, trauma, and forensics. Renea is an advocate and survivor for addictions treatment, trauma services, and domestic abuse. Renea offers a safe non-judgment free environment where accurate evidence based assessments are conducted for forensic evaluations.
Renea Snyder is focused on evidence based holistic treatment for those afflicted with the disease of addiction, trauma, and forensics. Renea is an advocate and survivor for addictions treatment, trauma services, and domestic abuse. Renea offers a safe non-judgment free environment where accurate evidence based assessments are conducted for forensic evaluations.
![Photo of Yvette D Bailey, MSW, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/1e65cabc-46cf-4637-a9a1-c84b8d6e7a6b/2/320x400.jpeg)
Yvette D Bailey
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
Enola, PA 17025 (Online Only)
Waitlist for new clients
Are you new or returning back to therapy? I'm Yvette, and I want to help you with your therapeutic journey. I work with BIPOC adults who now decided to make their mental health and personal goals a priority. I consider myself your personal Navigator during your mental health journey by providing clinical feedback, trust, active listening, personal accountability, and homework to help you reach your therapeutic goals. Life Coaching is also available for those who want to work on short term goals, accountability, and their personal development.
Are you new or returning back to therapy? I'm Yvette, and I want to help you with your therapeutic journey. I work with BIPOC adults who now decided to make their mental health and personal goals a priority. I consider myself your personal Navigator during your mental health journey by providing clinical feedback, trust, active listening, personal accountability, and homework to help you reach your therapeutic goals. Life Coaching is also available for those who want to work on short term goals, accountability, and their personal development.
![Photo of Matthew Berliant, LCSW, CCTP, Clinical Social Work/Therapist](https://photos.psychologytoday.com/df0c0517-75ec-4391-87fc-6f943ca8829f/3/320x400.jpeg)
Matthew Berliant
Clinical Social Work/Therapist, LCSW, CCTP
Verified Verified
2 Endorsed
Enola, PA 17025 (Online Only)
You deserve more - more happiness, more confidence, more pleasure in your life! And I believe I can help you get there. I am currently offering video sessions throughout the state of Pennsylvania during normal business hours, Monday through Friday 8am - 5pm. I also offer a sliding scale based on financial need. Please email me if you require a sliding scale and we can decide together how to fit therapy into your budget.
You deserve more - more happiness, more confidence, more pleasure in your life! And I believe I can help you get there. I am currently offering video sessions throughout the state of Pennsylvania during normal business hours, Monday through Friday 8am - 5pm. I also offer a sliding scale based on financial need. Please email me if you require a sliding scale and we can decide together how to fit therapy into your budget.
![Photo of Lancaster White Deer Run - White Deer Run of Lancaster, Drug & Alcohol Counselor](https://photos.psychologytoday.com/44efb7ee-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
From a beautiful tree-lined street in historic downtown Lancaster, we at White Deer Run of Lancaster have been helping men suffering from substance abuse disorders since 1999. Our short-term residential rehab program has proven successful at healing a variety of chemical dependency issues and some mild co-occurring mental health disorders. We know that each man's journey will be different and our goal is to provide empowering, personalized care unique to each patient's specific needs.
From a beautiful tree-lined street in historic downtown Lancaster, we at White Deer Run of Lancaster have been helping men suffering from substance abuse disorders since 1999. Our short-term residential rehab program has proven successful at healing a variety of chemical dependency issues and some mild co-occurring mental health disorders. We know that each man's journey will be different and our goal is to provide empowering, personalized care unique to each patient's specific needs.
![Photo of Jill Marshall, MS, Psychologist](https://photos.psychologytoday.com/44f93b6c-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
Jill Marshall
Psychologist, MS
Verified Verified
Enola, PA 17025 (Online Only)
Not accepting new clients
I have a practical, interactive, direct and goal oriented approach to therapy. I see myself as your guide. My goal is to teach you the tools needed to thrive not just survive.
I have a practical, interactive, direct and goal oriented approach to therapy. I see myself as your guide. My goal is to teach you the tools needed to thrive not just survive.
![Photo of Kathleen Kohlhaas, MS, NCC, LPC, Licensed Professional Counselor](https://photos.psychologytoday.com/452bc2e0-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
I am a licensed professional counselor who can help you make permanent, positive changes in your life. I offer compassion and expertise dealing with depression, anxiety, grief, relationship problems, anger, mood swings, or simply processing emotional life struggles of any kind. You will find a safe, non-judgmental environment to explore your challenges with a fresh perspective. My style is supportive and flexible, focusing on strengths and the relationship among thoughts, feelings and behaviors to guide healing and change.
I am a licensed professional counselor who can help you make permanent, positive changes in your life. I offer compassion and expertise dealing with depression, anxiety, grief, relationship problems, anger, mood swings, or simply processing emotional life struggles of any kind. You will find a safe, non-judgmental environment to explore your challenges with a fresh perspective. My style is supportive and flexible, focusing on strengths and the relationship among thoughts, feelings and behaviors to guide healing and change.
![Photo of Talayna Bowersox, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/55589678-8609-421e-8124-046aeee43c4b/2/320x400.jpeg)
Talayna Bowersox
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Enola, PA 17025
Waitlist for new clients
The first step is recognizing your desire to change and having a therapist who can validate and empower you is very important. My primary goal is to create a safe, non-judgmental, and supportive environment where you can feel comfortable expressing yourself. I utilize cognitive behavioral therapy, person-centered therapy, and strength-based approaches to allow you to become more self-aware and grow in a positive direction. My focus is meeting you where you are at, helping you learn new approaches, viewing things in a different light, and achieving your goals.
The first step is recognizing your desire to change and having a therapist who can validate and empower you is very important. My primary goal is to create a safe, non-judgmental, and supportive environment where you can feel comfortable expressing yourself. I utilize cognitive behavioral therapy, person-centered therapy, and strength-based approaches to allow you to become more self-aware and grow in a positive direction. My focus is meeting you where you are at, helping you learn new approaches, viewing things in a different light, and achieving your goals.
![Photo of Daniel J Snock, MS, Licensed Professional Counselor](https://photos.psychologytoday.com/a9fe5005-89bc-4738-bfa9-5fd16b5165b7/3/320x400.jpeg)
Life comes with challenges but they don't have to define us. I view counseling as a collaborative relationship between the client and counselor. This collaborative relationship allows us to figure out what the you are missing in your life, what you are in need of, or what you are burdened by. We work together to address what you are facing through the development of a therapeutic relationship where the you can feel supported and heard.
Life comes with challenges but they don't have to define us. I view counseling as a collaborative relationship between the client and counselor. This collaborative relationship allows us to figure out what the you are missing in your life, what you are in need of, or what you are burdened by. We work together to address what you are facing through the development of a therapeutic relationship where the you can feel supported and heard.
![Photo of Gloria Ward, MA, MS, NCC, BCC, Pre-Licensed Professional](https://photos.psychologytoday.com/c94f6f20-894a-40c7-b8f3-5b0e0f127ce3/1/320x400.png)
Gloria Ward
Pre-Licensed Professional, MA, MS, NCC, BCC
Verified Verified
2 Endorsed
Enola, PA 17025
Hi, I'm Gloria! Thank you for pausing here. Deciding to look for help was hard to begin with and finding the right helper seems even more difficult, I know. Whatever issues you are facing, perhaps its depression that is attached to your past, stress related to your present, or anxiety that is attaching itself to your future, I can help you work through it. It’s a privilege for me to be able to share lessons of hope and walk alongside my clients, until they have the breakthrough that they so desperately desire. My greatest joy is to see you step out from darkness into a brighter, lighter future – stronger, wiser, and hopeful!
Hi, I'm Gloria! Thank you for pausing here. Deciding to look for help was hard to begin with and finding the right helper seems even more difficult, I know. Whatever issues you are facing, perhaps its depression that is attached to your past, stress related to your present, or anxiety that is attaching itself to your future, I can help you work through it. It’s a privilege for me to be able to share lessons of hope and walk alongside my clients, until they have the breakthrough that they so desperately desire. My greatest joy is to see you step out from darkness into a brighter, lighter future – stronger, wiser, and hopeful!
![Photo of Cynthia Bartok - Downtown Counseling Center LLC, PhD](https://photos.psychologytoday.com/45e364de-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
Downtown Counseling Center (DCC) has specialty trained providers whose mission is to provide an individually tailored therapy experience to address the concerns of our clients. Our providers use empirically supported, research based interventions to help children, adolescents, adults or families reach treatment goals.
Downtown Counseling Center (DCC) has specialty trained providers whose mission is to provide an individually tailored therapy experience to address the concerns of our clients. Our providers use empirically supported, research based interventions to help children, adolescents, adults or families reach treatment goals.
More Therapists Nearby
![Photo of Jennifer Dougher, MA, LPC, Licensed Professional Counselor](https://photos.psychologytoday.com/19c45801-29ac-46ed-9440-708ca9997ec5/2/320x400.jpeg)
Jennifer Dougher
Licensed Professional Counselor, MA, LPC
Verified Verified
2 Endorsed
Lemoyne, PA 17043
Not accepting new clients
Allowing ourselves to be vulnerable enough to share hopes, fears and trauma can be very scary and difficult. My hope is that I could provide clients with a safe, comfortable space to allow vulnerability which can lead to healing and growth. I have been working in the mental health field for 21 years in different capacities. I do not specialize or take on court-ordered or custody assessment cases. If you are 8 years of age or older, experiencing symptoms that are leading to difficulty with living life, relationships or in work/school, please reach out to schedule an appointment so we can use compassion to help you find your path.
Allowing ourselves to be vulnerable enough to share hopes, fears and trauma can be very scary and difficult. My hope is that I could provide clients with a safe, comfortable space to allow vulnerability which can lead to healing and growth. I have been working in the mental health field for 21 years in different capacities. I do not specialize or take on court-ordered or custody assessment cases. If you are 8 years of age or older, experiencing symptoms that are leading to difficulty with living life, relationships or in work/school, please reach out to schedule an appointment so we can use compassion to help you find your path.
![Photo of Diane Michelle Edmond - Diane Edmond Therapy and LPC Supervsion, MS, LPC, CAADC, Licensed Professional Counselor](https://photos.psychologytoday.com/3fd76034-46cd-11ea-a6ad-06142c356176/3/320x400.jpeg)
Diane Edmond Therapy and LPC Supervsion
Licensed Professional Counselor, MS, LPC, CAADC
Verified Verified
1 Endorsed
Harrisburg, PA 17110
Waitlist for new clients
Are you struggling with depression, anxiety or bipolar disorder? Are you coping with the aftermath of trauma, abuse or effects of active military experience? Are you or a family member using drugs or alcohol to self-medicate? My clinical experience includes over 25 years in the field working in a variety of settings including inpatient and outpatient substance abuse, outpatient mental health , and working with children in foster care. I have an eclectic approach with a emphasis on cognitive therapy. I have an advanced certification in addictions and extensive work with trauma including EMDR.
Are you struggling with depression, anxiety or bipolar disorder? Are you coping with the aftermath of trauma, abuse or effects of active military experience? Are you or a family member using drugs or alcohol to self-medicate? My clinical experience includes over 25 years in the field working in a variety of settings including inpatient and outpatient substance abuse, outpatient mental health , and working with children in foster care. I have an eclectic approach with a emphasis on cognitive therapy. I have an advanced certification in addictions and extensive work with trauma including EMDR.
![Photo of Sara Weand, LPC, NCC, Licensed Professional Counselor](https://photos.psychologytoday.com/4610c8d2-46cd-11ea-a6ad-06142c356176/2/320x400.jpeg)
Sara Weand
Licensed Professional Counselor, LPC, NCC
Verified Verified
5 Endorsed
New Kingstown, PA 17072 (Online Only)
Your relationships are falling apart, you’re anxious all of the time, and your life has become an out-of-control mess. You wonder why relationships have to be so hard and cause you so much pain. People just don’t get it. They don’t get that when you’re hurt, your emotions take over and consume you. You’d literally do anything to not feel that way. In fact, when you have, you ended up feeling even worse and pushing those very same people away. You’re so desperate for people’s approval and terrified that if they ever found out what you’re really like, they wouldn’t want you anymore.
Your relationships are falling apart, you’re anxious all of the time, and your life has become an out-of-control mess. You wonder why relationships have to be so hard and cause you so much pain. People just don’t get it. They don’t get that when you’re hurt, your emotions take over and consume you. You’d literally do anything to not feel that way. In fact, when you have, you ended up feeling even worse and pushing those very same people away. You’re so desperate for people’s approval and terrified that if they ever found out what you’re really like, they wouldn’t want you anymore.
Hello. I have over 20 yrs of clinical experience with children, teens, and adults. I grew up in central Pennsylvania and attended Penn State for undergraduate schooling. I then earned a Ph.D. in Clinical Psychology from Central Michigan University and later a masters degree in Psychopharmacology from Argosy University. I also completed a two year fellowship in Clinical Child Psychology to work with children, teens, and families. I enjoy working with all age groups. Whether you are a parent wanting support for your child or teenager or an adult I would be happy to help you.
Hello. I have over 20 yrs of clinical experience with children, teens, and adults. I grew up in central Pennsylvania and attended Penn State for undergraduate schooling. I then earned a Ph.D. in Clinical Psychology from Central Michigan University and later a masters degree in Psychopharmacology from Argosy University. I also completed a two year fellowship in Clinical Child Psychology to work with children, teens, and families. I enjoy working with all age groups. Whether you are a parent wanting support for your child or teenager or an adult I would be happy to help you.
![Photo of John Mekhail, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/f195636b-a253-474a-b686-9c78c2a143da/2/320x400.jpeg)
John Mekhail
Clinical Social Work/Therapist, LCSW
Verified Verified
Camp Hill, PA 17011 (Online Only)
My name is John Mekhail and I am a LCSW, who has been working as a certified Dialectical Behavior Therapist for the last 3 years. I find DBT therapy to be quite fascinating, and complements CBT very well, while also focusing on some key aspects not addressed in CBT.
My name is John Mekhail and I am a LCSW, who has been working as a certified Dialectical Behavior Therapist for the last 3 years. I find DBT therapy to be quite fascinating, and complements CBT very well, while also focusing on some key aspects not addressed in CBT.
![Photo of Christine M Samuelsen, PsyD, Psychologist](https://photos.psychologytoday.com/c133370a-bbf5-4cd3-9b18-c8a6a085b2e7/1/320x400.jpeg)
Christine M Samuelsen
Psychologist, PsyD
Verified Verified
Harrisburg, PA 17102
Not accepting new clients
Reaching out for professional support when life is feeling challenging can be difficult, but know you are not alone. People decide to come to therapy for a wide variety of reasons- you may be struggling with mental or emotional distress, desire to change behaviors or you may want to gain a new perspective on your life. Whatever your reasons for seeking help, I am here to offer you a warm, supportive environment to help you work through the difficulties you are facing.
Reaching out for professional support when life is feeling challenging can be difficult, but know you are not alone. People decide to come to therapy for a wide variety of reasons- you may be struggling with mental or emotional distress, desire to change behaviors or you may want to gain a new perspective on your life. Whatever your reasons for seeking help, I am here to offer you a warm, supportive environment to help you work through the difficulties you are facing.
![Photo of Katie Henson, MSW, LCSW, Clinical Social Work/Therapist](https://photos.psychologytoday.com/a1f0a7f6-d4a5-4c05-bade-b0a5f940edce/3/320x400.jpeg)
Katie Henson
Clinical Social Work/Therapist, MSW, LCSW
Verified Verified
1 Endorsed
Harrisburg, PA 17102
The work I do is unique to each individual. Your life story is your own and finding a place to feel empowered, validated, challenged, and grown in healthy and supportive ways is waiting for you. By utilizing numerous modalities, approaches, techniques, and skills, I am able to offer you a place to reconnect with or discover your worth and value. I typically see individuals ages 16 and over as well as couples.
The work I do is unique to each individual. Your life story is your own and finding a place to feel empowered, validated, challenged, and grown in healthy and supportive ways is waiting for you. By utilizing numerous modalities, approaches, techniques, and skills, I am able to offer you a place to reconnect with or discover your worth and value. I typically see individuals ages 16 and over as well as couples.
![Photo of Sha-Ron Allen, LPC, Licensed Professional Counselor](https://photos.psychologytoday.com/4eb1e426-46cd-11ea-a6ad-06142c356176/3/320x400.jpeg)
Sha-Ron Allen
Licensed Professional Counselor, LPC
Verified Verified
Harrisburg, PA 17102
Not accepting new clients
There are times when you may feel the push and pull of everyday life. These issues may be personal and professional, and you are unable to fully show up to deal with these challenges. People choose therapy for a variety of reasons. Whether its anxiety, anger, or relationship issues, it’s overwhelming at best and have created barriers to living your best life. Therapy can help you uncover things that keep you stuck and help you gain insight into yourself.
There are times when you may feel the push and pull of everyday life. These issues may be personal and professional, and you are unable to fully show up to deal with these challenges. People choose therapy for a variety of reasons. Whether its anxiety, anger, or relationship issues, it’s overwhelming at best and have created barriers to living your best life. Therapy can help you uncover things that keep you stuck and help you gain insight into yourself.
![Photo of Robert E Wilson, MA, LPC, Licensed Professional Counselor](https://photos.psychologytoday.com/d09622e0-ef76-4312-a858-e5db2fd21a6c/3/320x400.jpeg)
In my practice, I enjoy working collaboratively with my clients to help them find solutions to the issues that have been bothering them. I value creating a strong, trusting relationship with my clients so that they feel comfortable and confident in our work together. My style is warm and interactive and I utilize a client centered approach, meaning that I place strong value on your experiences and the lens through which you see the world. My goal is to help you find your best path toward change and personal growth by creating a supportive space in which to explore.
In my practice, I enjoy working collaboratively with my clients to help them find solutions to the issues that have been bothering them. I value creating a strong, trusting relationship with my clients so that they feel comfortable and confident in our work together. My style is warm and interactive and I utilize a client centered approach, meaning that I place strong value on your experiences and the lens through which you see the world. My goal is to help you find your best path toward change and personal growth by creating a supportive space in which to explore.
See more therapy options for Enola
How does your Therapist compare?
Number of Therapists in Enola, PA
10+
Average cost per session
$140
Therapists in Enola, PA who prioritize treating:
100% | Coping Skills |
82% | Depression |
82% | Anxiety |
82% | Stress |
64% | Relationship Issues |
64% | Peer Relationships |
64% | Self Esteem |
Average years in practice
13 Years
Top 3 insurances accepted
89% | Highmark |
78% | Aetna |
78% | BlueCross and BlueShield |
How Therapists in Enola, PA see their clients
55% | In Person and Online | |
45% | Online Only |
Gender breakdown
78% | Female | |
11% | Male | |
11% | Non-Binary |
FAQs - About Therapy and Counseling
How can I find a therapist in Enola?
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.