Therapists in West Hartford, CT

Photo of Yona Skoler, LMSW, Clinical Social Work/Therapist
Yona Skoler
Clinical Social Work/Therapist, LMSW
Verified Verified
West Hartford, CT 06107  (Online Only)
Whether you’re grappling with intimate relationship issues, evolving familial dynamics, the pain of grief, or other challenges, my goal is to provide empathetic support and helpful strategies. I hope to collaborate with you to create a treatment plan that is sustainable, effective, and empowering. With an understanding of how frustrating it can be when others make assumptions about your personal issues, I focus on creating a space where clients can share their narratives without being judged or minimized.
Whether you’re grappling with intimate relationship issues, evolving familial dynamics, the pain of grief, or other challenges, my goal is to provide empathetic support and helpful strategies. I hope to collaborate with you to create a treatment plan that is sustainable, effective, and empowering. With an understanding of how frustrating it can be when others make assumptions about your personal issues, I focus on creating a space where clients can share their narratives without being judged or minimized.
(860) 454-6762 View (860) 454-6762
Photo of Jill deRosas, LCSW, Clinical Social Work/Therapist
Jill deRosas
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
West Hartford, CT 06107  (Online Only)
Whether you are starting or continuing on your therapy journey, I am proud of you for taking the steps to do what is best for you! I help teens, emerging adults, and adult clients with anxiety, depression, trauma, adjustments and life transitions. I provide a client-centered and intersectional approach to therapy to make sure clients feel comfortable and at ease as they go through this vulnerable process. I approach my therapy sessions with warmth, compassion, and a sense of humor. If you are looking for a validating, empowering space where you can feel seen and heard, I am here to help support you in reaching your goals.
Whether you are starting or continuing on your therapy journey, I am proud of you for taking the steps to do what is best for you! I help teens, emerging adults, and adult clients with anxiety, depression, trauma, adjustments and life transitions. I provide a client-centered and intersectional approach to therapy to make sure clients feel comfortable and at ease as they go through this vulnerable process. I approach my therapy sessions with warmth, compassion, and a sense of humor. If you are looking for a validating, empowering space where you can feel seen and heard, I am here to help support you in reaching your goals.
(860) 780-7515 View (860) 780-7515
Photo of Allison Kilty, LMSW, Clinical Social Work/Therapist
Allison Kilty
Clinical Social Work/Therapist, LMSW
Verified Verified
1 Endorsed
West Hartford, CT 06107
My ideal client is someone navigating the complexities of anxiety, depression, or the everyday challenges of life, who is open to exploring the connection between the mind and body, and are seeking a holistic approach to creating balance, reducing stress, and enhancing their emotions and well-being. Their goals include achieving a greater sense of peace, gaining clarity, and building resilience. They desire a compassionate and supportive environment where they can explore their feelings and develop a toolkit for their healing journey, recognizing the courage it takes to seek help.
My ideal client is someone navigating the complexities of anxiety, depression, or the everyday challenges of life, who is open to exploring the connection between the mind and body, and are seeking a holistic approach to creating balance, reducing stress, and enhancing their emotions and well-being. Their goals include achieving a greater sense of peace, gaining clarity, and building resilience. They desire a compassionate and supportive environment where they can explore their feelings and develop a toolkit for their healing journey, recognizing the courage it takes to seek help.
(860) 968-2982 View (860) 968-2982
Photo of David Bendor, PsyD, Psychologist
David Bendor
Psychologist, PsyD
Verified Verified
2 Endorsed
West Hartford, CT 06107
I specialize in treating those teenagers, young adults, and adults whose lives have been negatively impacted by mental illness and/or significant life stressors. In my practice I help individuals treat the symptoms that are causing the most distress so they can begin to overcome the obstacles to health, fulfillment, and contentedness. When appropriate I provide psychoeducation to the family members and advise them in how they can best support the individual's recovery.
I specialize in treating those teenagers, young adults, and adults whose lives have been negatively impacted by mental illness and/or significant life stressors. In my practice I help individuals treat the symptoms that are causing the most distress so they can begin to overcome the obstacles to health, fulfillment, and contentedness. When appropriate I provide psychoeducation to the family members and advise them in how they can best support the individual's recovery.
(860) 331-8649 View (860) 331-8649
Photo of Laurie Taylor, LPC, Licensed Professional Counselor
Laurie Taylor
Licensed Professional Counselor, LPC
Verified Verified
1 Endorsed
West Hartford, CT 06117
Not accepting new clients
In facing life’s challenges, I believe in the importance of asking ourselves, “What’s right with me?” and identifying and building on our strengths. I enjoy accompanying people in exploring themselves with non-judgmental curiosity as they develop greater awareness of their thoughts, feelings, and ways of dealing with whatever life has in store. How have these been influenced by personal experiences growing up and by larger social factors? Gaining this insight allows us to discover what changes might be right for us or to come to accept ourselves just as we are.
In facing life’s challenges, I believe in the importance of asking ourselves, “What’s right with me?” and identifying and building on our strengths. I enjoy accompanying people in exploring themselves with non-judgmental curiosity as they develop greater awareness of their thoughts, feelings, and ways of dealing with whatever life has in store. How have these been influenced by personal experiences growing up and by larger social factors? Gaining this insight allows us to discover what changes might be right for us or to come to accept ourselves just as we are.
(860) 530-4280 View (860) 530-4280
Photo of Sydney Lyons, LCSW, Clinical Social Work/Therapist
Sydney Lyons
Clinical Social Work/Therapist, LCSW
Verified Verified
West Hartford, CT 06107
Hey there! I'm so glad you're considering therapy. As a Licensed Clinical Social Worker with a passion for helping people, I've had the privilege of working with kids, teens, and adults in individual, group, and family settings throughout Connecticut. My clients are most often older teens, college age, and young adults needing support. Everyone's journey is unique, which is why I'm committed to creating a safe and non-judgmental space where you can freely express yourself.
Hey there! I'm so glad you're considering therapy. As a Licensed Clinical Social Worker with a passion for helping people, I've had the privilege of working with kids, teens, and adults in individual, group, and family settings throughout Connecticut. My clients are most often older teens, college age, and young adults needing support. Everyone's journey is unique, which is why I'm committed to creating a safe and non-judgmental space where you can freely express yourself.
(860) 864-4665 View (860) 864-4665
Photo of Stacie J. Watson, LMFT, CPC, Marriage & Family Therapist
Stacie J. Watson
Marriage & Family Therapist, LMFT, CPC
Verified Verified
West Hartford, CT 06119
I specialize in working with individuals who may be experiencing some sort of transition or change in their lives. This may include issues related to work, depression/anxiety and/or sexual/gender orientation. I began my career as an independent counselor and over time, transitioned into a corporate healthcare setting. I utilize a 'coaching' approach which focuses on current issues and the creating of real-time strategies to address these issues. My clients are often focused on career issues, work/life balance and the search for an understanding of oneself more fully.
I specialize in working with individuals who may be experiencing some sort of transition or change in their lives. This may include issues related to work, depression/anxiety and/or sexual/gender orientation. I began my career as an independent counselor and over time, transitioned into a corporate healthcare setting. I utilize a 'coaching' approach which focuses on current issues and the creating of real-time strategies to address these issues. My clients are often focused on career issues, work/life balance and the search for an understanding of oneself more fully.
(860) 866-1413 View (860) 866-1413
Photo of Lisa Langweil, MS, CCC-SLP
Lisa Langweil
MS, CCC-SLP
Verified Verified
West Hartford, CT 06107
You are not alone; If you need me, I’m here to help! I provide assessment, intervention, education and coaching for children and adults with speech, language, and cognitive- communication difficulties due developmentally and/or neurologically based issues. I’ve been fortunate to have worked in a variety of settings providing me with a wide array of experiences. After 28 years of experience, I continue to love my field of work and my passion translates into providing quality care to my clients and their families. Helping individuals and their families learn, grow and become more confident and competent communicators is important.
You are not alone; If you need me, I’m here to help! I provide assessment, intervention, education and coaching for children and adults with speech, language, and cognitive- communication difficulties due developmentally and/or neurologically based issues. I’ve been fortunate to have worked in a variety of settings providing me with a wide array of experiences. After 28 years of experience, I continue to love my field of work and my passion translates into providing quality care to my clients and their families. Helping individuals and their families learn, grow and become more confident and competent communicators is important.
(860) 485-7953 View (860) 485-7953
Photo of Rick Blum - Rick Blum, PhD., PhD, Psychologist
Rick Blum, PhD.
Psychologist, PhD
Verified Verified
West Hartford, CT 06119
Waitlist for new clients
The best way to find about me is to check out my web site, dr-rick.com. There, you'll get a good sense of my perspective and how I view life's challenges and opportunities. Don't miss the "blum-blog." My style of practice is ideal for people who want real change in their lives, who expect that their therapist knows how to achieve this, and who are eager to learn about themselves in order to make it happen. The best approach includes our becoming a team, each bringing our part to the adventure.
The best way to find about me is to check out my web site, dr-rick.com. There, you'll get a good sense of my perspective and how I view life's challenges and opportunities. Don't miss the "blum-blog." My style of practice is ideal for people who want real change in their lives, who expect that their therapist knows how to achieve this, and who are eager to learn about themselves in order to make it happen. The best approach includes our becoming a team, each bringing our part to the adventure.
(860) 650-1286 View (860) 650-1286
Photo of Robin M. Gilmartin, LCSW, Clinical Social Work/Therapist
Robin M. Gilmartin
Clinical Social Work/Therapist, LCSW
Verified Verified
2 Endorsed
West Hartford, CT 06119
Not accepting new clients
Welcome! I specialize in helping individuals with anxiety-related problems (including panic, specific fears and general anxiety), those who've suffered traumatic losses or are experiencing life transitions (such as divorce, job loss, military discharge, illness or retirement). I bring 20 years of experience and skills to my work but also know it's the relationship with each client - the caring, trust and collaboration - that is key to recovery and personal growth. Many people prefer to contact me at first by email and we may email several times before you decide to schedule an appointment. That's fine.
Welcome! I specialize in helping individuals with anxiety-related problems (including panic, specific fears and general anxiety), those who've suffered traumatic losses or are experiencing life transitions (such as divorce, job loss, military discharge, illness or retirement). I bring 20 years of experience and skills to my work but also know it's the relationship with each client - the caring, trust and collaboration - that is key to recovery and personal growth. Many people prefer to contact me at first by email and we may email several times before you decide to schedule an appointment. That's fine.
(860) 756-5228 View (860) 756-5228
Photo of Adalicia Ramos, LCSW, LMSW, MSW, Clinical Social Work/Therapist
Adalicia Ramos
Clinical Social Work/Therapist, LCSW, LMSW, MSW
Verified Verified
West Hartford, CT 06107
We all face personal struggles and difficult experiences that can feel overwhelming, especially when we struggle with them alone. As your clinician, I use a collaborative process to help you find ways to identify distressing symptoms and develop a comprehensive plan to improve functioning and find relief. I am a bilingual licensed clinical social worker with a background in treating children, teens, and adults who experience a variety of challenges including but not limited to trauma, anxiety, depression, and OCD. I offer various clinical interventions in a safe environment where my clients can explore their experiences.
We all face personal struggles and difficult experiences that can feel overwhelming, especially when we struggle with them alone. As your clinician, I use a collaborative process to help you find ways to identify distressing symptoms and develop a comprehensive plan to improve functioning and find relief. I am a bilingual licensed clinical social worker with a background in treating children, teens, and adults who experience a variety of challenges including but not limited to trauma, anxiety, depression, and OCD. I offer various clinical interventions in a safe environment where my clients can explore their experiences.
(860) 397-2073 View (860) 397-2073
Photo of Latoya Hinds, DSW, LCSW, Clinical Social Work/Therapist
Latoya Hinds
Clinical Social Work/Therapist, DSW, LCSW
Verified Verified
West Hartford, CT 06110
Not accepting new clients
Have you been feeling down and experiencing symptoms related to anxiety, depression or trauma? Are you experiencing difficulty in adjusting to life changes as it relates to your relationships, education and/or career path? Maybe you are adjusting to parenthood and are in need of support?
Have you been feeling down and experiencing symptoms related to anxiety, depression or trauma? Are you experiencing difficulty in adjusting to life changes as it relates to your relationships, education and/or career path? Maybe you are adjusting to parenthood and are in need of support?
(860) 398-9639 View (860) 398-9639
Photo of Bob Deutsch, PhD, Psychologist
Bob Deutsch
Psychologist, PhD
Verified Verified
West Hartford, CT 06107  (Online Only)
I am fortunate to have discovered that after forty years as a psychotherapist and teacher, that I continue to experience a growing passion for my work. I have worked as a clinical psychologist in private practice and in hospital settings for many years. In addition to my practice of General Psychology, I have developed specific areas of expertise.
I am fortunate to have discovered that after forty years as a psychotherapist and teacher, that I continue to experience a growing passion for my work. I have worked as a clinical psychologist in private practice and in hospital settings for many years. In addition to my practice of General Psychology, I have developed specific areas of expertise.
(860) 288-5305 View (860) 288-5305
Photo of Kathleen Cairns, PsyD, Psychologist
Kathleen Cairns
Psychologist, PsyD
Verified Verified
West Hartford, CT 06119
Kathleen Cairns, Psy.D. is a licensed clinical psychologist, hypnotherapist, and author of "The Psychotherapy Workbook","The Bald & The Beautiful: Surviving Breast Cancer, self-hypnosis audio tape "Breathe... As If Your Life Depended On It.," and lithographic greeting cards "Kathleen's Condolences." Her weekly column LIFE GOES ON can be read in her website. She is also frequently interviewed for the internet, magazines, and books regarding today’s social issues. Kathleen works with anxiety, depression,bipolar, addictions, sexual abuse, relationship issues, stress, grief, death, adolescents, and couples.
Kathleen Cairns, Psy.D. is a licensed clinical psychologist, hypnotherapist, and author of "The Psychotherapy Workbook","The Bald & The Beautiful: Surviving Breast Cancer, self-hypnosis audio tape "Breathe... As If Your Life Depended On It.," and lithographic greeting cards "Kathleen's Condolences." Her weekly column LIFE GOES ON can be read in her website. She is also frequently interviewed for the internet, magazines, and books regarding today’s social issues. Kathleen works with anxiety, depression,bipolar, addictions, sexual abuse, relationship issues, stress, grief, death, adolescents, and couples.
(860) 236-5555 View (860) 236-5555
Photo of Samantha Nunes, LMSW, Clinical Social Work/Therapist
Samantha Nunes
Clinical Social Work/Therapist, LMSW
Verified Verified
1 Endorsed
West Hartford, CT 06110
Whether you’re looking for support in better understanding yourself, navigating your healing journey, coping with your mental health, life’s transitions, trauma responses, relationships, self esteem or developing healthier coping skills, I'm here to help you reach your goals, create the future you envision for yourself, and ultimately thrive. I have a background in social work, serving diverse populations in school systems across CT and MA from pre-k all the way through higher education. I now offer therapeutic support to children, adolescents and young adults struggling with a range of social, emotional and behavioral challenges.
Whether you’re looking for support in better understanding yourself, navigating your healing journey, coping with your mental health, life’s transitions, trauma responses, relationships, self esteem or developing healthier coping skills, I'm here to help you reach your goals, create the future you envision for yourself, and ultimately thrive. I have a background in social work, serving diverse populations in school systems across CT and MA from pre-k all the way through higher education. I now offer therapeutic support to children, adolescents and young adults struggling with a range of social, emotional and behavioral challenges.
(860) 787-8577 View (860) 787-8577
Photo of Patrick Muro, LCSW, Clinical Social Work/Therapist
Patrick Muro
Clinical Social Work/Therapist, LCSW
Verified Verified
3 Endorsed
West Hartford, CT 06117  (Online Only)
Feeling anxious, isolated, or like you're constantly battling your inner critic? I'm passionate about supporting teens and adults who are struggling with anxiety, burnout, depression, disordered eating, neurodiversity, LGTBQ+ related issues, and more. You're not alone, and real change is possible. I use cognitive behavioral therapy to help people regain their sense of hope and build stronger connections. Together we will: 1. Identify and change negative thought patterns 2. Develop a more positive self-image 3. Boost your confidence in all areas of your life.
Feeling anxious, isolated, or like you're constantly battling your inner critic? I'm passionate about supporting teens and adults who are struggling with anxiety, burnout, depression, disordered eating, neurodiversity, LGTBQ+ related issues, and more. You're not alone, and real change is possible. I use cognitive behavioral therapy to help people regain their sense of hope and build stronger connections. Together we will: 1. Identify and change negative thought patterns 2. Develop a more positive self-image 3. Boost your confidence in all areas of your life.
View
Photo of Nayda LeMay, LADC, MFT, Drug & Alcohol Counselor
Nayda LeMay
Drug & Alcohol Counselor, LADC, MFT
Verified Verified
1 Endorsed
West Hartford, CT 06110
My approach is eclectic. I join you in the road to recovery. I consider myself culturally competent, trauma informed and gender sensitive. Therapy like most professions continue to evolve, therefore, I actively seek ways to improve the delivery of evidence based practices that I use. I strongly believe that each experience with clients I serve is unique and rewarding. My hope is to help clients begin the journey of achieving a life worth living.
My approach is eclectic. I join you in the road to recovery. I consider myself culturally competent, trauma informed and gender sensitive. Therapy like most professions continue to evolve, therefore, I actively seek ways to improve the delivery of evidence based practices that I use. I strongly believe that each experience with clients I serve is unique and rewarding. My hope is to help clients begin the journey of achieving a life worth living.
(860) 461-0504 View (860) 461-0504
Photo of Dr. Rachel Carlson, PsyD, Psychologist
Dr. Rachel Carlson
Psychologist, PsyD
Verified Verified
West Hartford, CT 06119
Waitlist for new clients
I am a Clinical Psychologist who specializes in working with teens, young adults, and adults, particularly around issues of life transitions, identity, values, and meaning. I have expertise in LGBTQ+ issues, depression and anxiety, trauma, OCD, and communication issues. I will never judge you for your darkness and will reflect your light back at you until you see it. I am passionate about helping you understand what is going on inside your brain so you don’t think you are broken. However, I believe you are the expert on your own life and we will work together to figure out what approach to therapy will meet your needs.
I am a Clinical Psychologist who specializes in working with teens, young adults, and adults, particularly around issues of life transitions, identity, values, and meaning. I have expertise in LGBTQ+ issues, depression and anxiety, trauma, OCD, and communication issues. I will never judge you for your darkness and will reflect your light back at you until you see it. I am passionate about helping you understand what is going on inside your brain so you don’t think you are broken. However, I believe you are the expert on your own life and we will work together to figure out what approach to therapy will meet your needs.
(860) 590-4686 View (860) 590-4686
Photo of Hope Ustanowski - Healing With Hope, LLC, LPC, MA, Licensed Professional Counselor
Healing With Hope, LLC
Licensed Professional Counselor, LPC, MA
Verified Verified
3 Endorsed
West Hartford, CT 06107
Not accepting new clients
I'm not currently accepting new clients at this time. Life sometimes takes us down a path that can be difficult, uneasy, and sometimes quite painful to deal with. Working together, we will create a safe, comfortable environment to help you walk down that path with a sense of hope that things can get better.
I'm not currently accepting new clients at this time. Life sometimes takes us down a path that can be difficult, uneasy, and sometimes quite painful to deal with. Working together, we will create a safe, comfortable environment to help you walk down that path with a sense of hope that things can get better.
(203) 409-8928 View (203) 409-8928
Photo of Melissa Morgan, LPC, Licensed Professional Counselor
Melissa Morgan
Licensed Professional Counselor, LPC
Verified Verified
West Hartford, CT 06105
Do you feel burdened or like you are not able to live life with freedom, joy and peace? Whether we have hurts from the past or anxiety and depression that seem overwhelming; it can be helpful to have someone there who understands and provides non-judgmental, supportive feedback. When we experience challenges, crisis and difficult circumstances; important goals in therapy are learning to identify how our thoughts trigger our emotions and developing coping skills to process them.
Do you feel burdened or like you are not able to live life with freedom, joy and peace? Whether we have hurts from the past or anxiety and depression that seem overwhelming; it can be helpful to have someone there who understands and provides non-judgmental, supportive feedback. When we experience challenges, crisis and difficult circumstances; important goals in therapy are learning to identify how our thoughts trigger our emotions and developing coping skills to process them.
(860) 200-3705 View (860) 200-3705
1
...

See more therapy options for West Hartford

How does your Therapist compare?

Number of Therapists in West Hartford, CT

600+

Average cost per session

$150

Therapists in West Hartford, CT who prioritize treating:

92% Anxiety
87% Depression
74% Self Esteem
72% Relationship Issues
70% Coping Skills
67% Trauma and PTSD
65% Stress

Average years in practice

12 Years

Top 3 insurances accepted

71% Aetna
68% Cigna and Evernorth
65% UnitedHealthcare UHC | UBH

How Therapists in West Hartford, CT see their clients

63% In Person and Online
37% Online Only

Gender breakdown

81% Female
18% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in West Hartford?

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.