Therapists in Fresno, CA

View neighborhoods in Fresno
Photo of Jessica Rice, MS, LMFT, Marriage & Family Therapist
Jessica Rice
Marriage & Family Therapist, MS, LMFT
Verified Verified
Fresno, CA 93711
Every person has their own reasons for seeking therapy. Some choose it during a period of major life transitions or hardships, while others may seek out therapy in order to deepen their understanding of themselves. By using a psychodynamic and object relations model I am able to consider the whole person rather than pure symptom reduction. I believe there is both conscious and unconscious meaning to symptoms.
Every person has their own reasons for seeking therapy. Some choose it during a period of major life transitions or hardships, while others may seek out therapy in order to deepen their understanding of themselves. By using a psychodynamic and object relations model I am able to consider the whole person rather than pure symptom reduction. I believe there is both conscious and unconscious meaning to symptoms.
(559) 366-6522 View (559) 366-6522
Photo of Ka Bao Adame, LMFT, Marriage & Family Therapist
Ka Bao Adame
Marriage & Family Therapist, LMFT
Verified Verified
Fresno, CA 93710
Are you feeling sad, anxious, stressed, or overwhelmed and unsure on how to navigate stressors in your life? Do you feel stuck in a cycle of unfulfilling relationships and self-destructive patterns? Do you feel lost because you are trying, but you are plagued with self doubt and crippled by fears? Whether you are looking for a therapist to help you through a difficult life transition or support with a family member/friends struggling with mental illness, I'm here to support you. My counseling approach is holistic, collaborative, and being culturally responsive using integrative mental health practices to empower personal growth.
Are you feeling sad, anxious, stressed, or overwhelmed and unsure on how to navigate stressors in your life? Do you feel stuck in a cycle of unfulfilling relationships and self-destructive patterns? Do you feel lost because you are trying, but you are plagued with self doubt and crippled by fears? Whether you are looking for a therapist to help you through a difficult life transition or support with a family member/friends struggling with mental illness, I'm here to support you. My counseling approach is holistic, collaborative, and being culturally responsive using integrative mental health practices to empower personal growth.
(559) 527-4068 View (559) 527-4068
Photo of Allyson Torres, LCSW, Clinical Social Work/Therapist
Allyson Torres
Clinical Social Work/Therapist, LCSW
Verified Verified
Fresno, CA 93711
My vision is to provide culturally competent, and solution-focused services that promote individuals’ social-emotional health and wellbeing, help to prevent the development of mental health challenges through mindfulness, and address key issues leading to one’s own mental health balance.
My vision is to provide culturally competent, and solution-focused services that promote individuals’ social-emotional health and wellbeing, help to prevent the development of mental health challenges through mindfulness, and address key issues leading to one’s own mental health balance.
(559) 380-4197 View (559) 380-4197
Photo of Barbara Fannin, PhD, Psychologist
Barbara Fannin
Psychologist, PhD
Verified Verified
Fresno, CA 93711  (Online Only)
Some problems can seem larger than they are. We need to get above them and see them from another perspective. That’s difficult to do because when we think about them, we always see it the same way. We may avoid thinking about it because that just makes us feel worse. Some say, why talk about it, that doesn’t help. However, you have not talked but thought about it. If you talk to someone who can see it from a different perspective, that helps shift thoughts in another more insightful direction and that’s the road to real change.
Some problems can seem larger than they are. We need to get above them and see them from another perspective. That’s difficult to do because when we think about them, we always see it the same way. We may avoid thinking about it because that just makes us feel worse. Some say, why talk about it, that doesn’t help. However, you have not talked but thought about it. If you talk to someone who can see it from a different perspective, that helps shift thoughts in another more insightful direction and that’s the road to real change.
(559) 242-4401 View (559) 242-4401
Photo of Snow Lee, LMFT, Marriage & Family Therapist
Snow Lee
Marriage & Family Therapist, LMFT
Verified Verified
2 Endorsed
Fresno, CA 93710  (Online Only)
Are you tired of being stuck? Have you tried to change but find yourself repeating the same mistakes? You have probably told yourself “I will change” or “things will get better,” but your quality of life have stayed the same? You are not alone as 1/3 of Americans are reported to be living under stress (APA, 2007). We are all unique individuals and we strive to be better but we often get stuck in a mental trap due to our past experiences. If you are here you have already initiated a small sequence of change, allow yourself to take it further.
Are you tired of being stuck? Have you tried to change but find yourself repeating the same mistakes? You have probably told yourself “I will change” or “things will get better,” but your quality of life have stayed the same? You are not alone as 1/3 of Americans are reported to be living under stress (APA, 2007). We are all unique individuals and we strive to be better but we often get stuck in a mental trap due to our past experiences. If you are here you have already initiated a small sequence of change, allow yourself to take it further.
(559) 354-6062 View (559) 354-6062
Photo of Katherine Hoover, LCSW, Clinical Social Work/Therapist
Katherine Hoover
Clinical Social Work/Therapist, LCSW
Verified Verified
Fresno, CA 93722
Hi, my name is Kati Hoover, and I am a Licensed Clinical Social Worker (LCSW) based in Long Beach, California and working with clients statewide via telehealth. I enjoy working with adolescents and young adults and specialize in anxiety, stress, depression, LGBTQ+ issues, self-esteem, and relationship issues. I use Cognitive Behavioral Therapy and Acceptance and Commitment Therapy to help my clients achieve their goals and start feeling better. I have found that my style and approach is a good fit for teens and young adults who may be dealing with the challenges of life transitions and social pressures.
Hi, my name is Kati Hoover, and I am a Licensed Clinical Social Worker (LCSW) based in Long Beach, California and working with clients statewide via telehealth. I enjoy working with adolescents and young adults and specialize in anxiety, stress, depression, LGBTQ+ issues, self-esteem, and relationship issues. I use Cognitive Behavioral Therapy and Acceptance and Commitment Therapy to help my clients achieve their goals and start feeling better. I have found that my style and approach is a good fit for teens and young adults who may be dealing with the challenges of life transitions and social pressures.
(559) 523-4135 View (559) 523-4135
Photo of Brandy Malloy, LCSW, Clinical Social Work/Therapist
Brandy Malloy
Clinical Social Work/Therapist, LCSW
Verified Verified
Fresno, CA 93727
My name is Brandy Malloy, and I'm a Licensed Clinical Therapist. I enjoy working with clients who are seeking support and guidance with the following issues: Stress management, grief/loss, anxiety, depression, couples counseling, women's health issues, self-esteem issues, and boundary setting.
My name is Brandy Malloy, and I'm a Licensed Clinical Therapist. I enjoy working with clients who are seeking support and guidance with the following issues: Stress management, grief/loss, anxiety, depression, couples counseling, women's health issues, self-esteem issues, and boundary setting.
(559) 254-4235 View (559) 254-4235
Photo of Donald Turnmire, MS, LMFT, 200 YTT, TCYM, EMDRIA, Marriage & Family Therapist
Donald Turnmire
Marriage & Family Therapist, MS, LMFT, 200 YTT, TCYM, EMDRIA
Verified Verified
Fresno, CA 93710
Life can be wonderful & harmonious, & it can also be complicated. Often times, we go through life learning to hide parts of ourselves that have felt criticism, fear & other difficult emotions (rejection, hurt, etc.). We learn to ignore those difficult parts of ourselves due to shame & guilt, which can lead to sadness, worry, low self-esteem, trauma, and so on. These emotions & hurts can also affect the relationships around us (romantic, friendships, work, etc.), causing deeper pain & rejection. We notice our emotions, mind, & body’s reaction to situations that cause these parts to resurface & then struggle to cope.
Life can be wonderful & harmonious, & it can also be complicated. Often times, we go through life learning to hide parts of ourselves that have felt criticism, fear & other difficult emotions (rejection, hurt, etc.). We learn to ignore those difficult parts of ourselves due to shame & guilt, which can lead to sadness, worry, low self-esteem, trauma, and so on. These emotions & hurts can also affect the relationships around us (romantic, friendships, work, etc.), causing deeper pain & rejection. We notice our emotions, mind, & body’s reaction to situations that cause these parts to resurface & then struggle to cope.
(559) 235-1906 View (559) 235-1906
Photo of Nicole R. Luk, PhD, Psychologist
Nicole R. Luk
Psychologist, PhD
Verified Verified
2 Endorsed
Fresno, CA 93704
Not accepting new clients
I typically treat patients with long-standing difficulties in their life. They have usually made numerous attempts to resolve internal distress and conflict in relationships with varying degrees of success. The type of therapy I offer is intensive and seeks to provide the patient with the tools to understand their pattern of behavior, decrease emotional distress, manage conflict, and adopt realistic expectations for themselves and others.
I typically treat patients with long-standing difficulties in their life. They have usually made numerous attempts to resolve internal distress and conflict in relationships with varying degrees of success. The type of therapy I offer is intensive and seeks to provide the patient with the tools to understand their pattern of behavior, decrease emotional distress, manage conflict, and adopt realistic expectations for themselves and others.
(559) 317-6669 View (559) 317-6669
Photo of Jeanine Yoder, LCSW, Clinical Social Work/Therapist
Jeanine Yoder
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Fresno, CA 93704
Along life's journey, there are markers that shape who we have become and how we engage with ourselves and others. Together, we will explore your childhood, relationships, points of crisis, negative looping thoughts, and feelings. In our work, we will look for paths that help you become more aware of your strengths and struggles so you can navigate challenges you may have with depression, anxieties, feeling lost, motivation, and current relationships.
Along life's journey, there are markers that shape who we have become and how we engage with ourselves and others. Together, we will explore your childhood, relationships, points of crisis, negative looping thoughts, and feelings. In our work, we will look for paths that help you become more aware of your strengths and struggles so you can navigate challenges you may have with depression, anxieties, feeling lost, motivation, and current relationships.
(559) 337-6670 View (559) 337-6670
Photo of Shawna Acunia, LMFT, Marriage & Family Therapist
Shawna Acunia
Marriage & Family Therapist, LMFT
Verified Verified
3 Endorsed
Fresno, CA 93722  (Online Only)
Are you a parent concerned about your teen's well-being? Is your teenager facing academic stress, struggling with peer relationships, or navigating the challenges of adolescence? I specialize in working with teens, offering a unique blend of expertise, empathy, and a deep understanding of adolescent development. With a passion for empowering young minds, I create a safe and supportive space for teens to thrive. Whether it's academic pressure, peer dynamics, identity exploration, or family challenges, I am equipped to guide your teen through these crucial years.
Are you a parent concerned about your teen's well-being? Is your teenager facing academic stress, struggling with peer relationships, or navigating the challenges of adolescence? I specialize in working with teens, offering a unique blend of expertise, empathy, and a deep understanding of adolescent development. With a passion for empowering young minds, I create a safe and supportive space for teens to thrive. Whether it's academic pressure, peer dynamics, identity exploration, or family challenges, I am equipped to guide your teen through these crucial years.
View
Photo of Sara Fierro, LMFT, Marriage & Family Therapist
Sara Fierro
Marriage & Family Therapist, LMFT
Verified Verified
Fresno, CA 93727
My name is Sara Fierro, I am dually licensed in California as a Marriage and Family Therapist and a Professional Clinical Counselor. My focus areas include, but are not limited to, anxiety, trauma and resilience, depression, LGBTQIA+, life transitions, spirituality, interpersonal relationships/relational conflict, women's issues, dual diagnosis, ADHD, parenting, and self-esteem. I have an eclectic approach to therapy because I utilize interventions and skills from many theoretical orientations, including Client-Centered, Narrative, CBT, Motivational Interviewing, Solution-Focused, Strength-Based, Holistic, and Interpersonal
My name is Sara Fierro, I am dually licensed in California as a Marriage and Family Therapist and a Professional Clinical Counselor. My focus areas include, but are not limited to, anxiety, trauma and resilience, depression, LGBTQIA+, life transitions, spirituality, interpersonal relationships/relational conflict, women's issues, dual diagnosis, ADHD, parenting, and self-esteem. I have an eclectic approach to therapy because I utilize interventions and skills from many theoretical orientations, including Client-Centered, Narrative, CBT, Motivational Interviewing, Solution-Focused, Strength-Based, Holistic, and Interpersonal
(559) 342-2573 View (559) 342-2573
Photo of Nancy Lynch, MA, LMFT, PsyD(C), Marriage & Family Therapist
Nancy Lynch
Marriage & Family Therapist, MA, LMFT, PsyD(C)
Verified Verified
1 Endorsed
Fresno, CA 93704
My focus as a psychotherapist is to assist you to achieve your unique goals. I create a genuine, safe and supportive environment so you can feel comfortable expressing yourself. My goal is to enable you to explore yourself so you become more confident and assertive. You will be empowered to make changes that lead to greater satisfaction in your life.
My focus as a psychotherapist is to assist you to achieve your unique goals. I create a genuine, safe and supportive environment so you can feel comfortable expressing yourself. My goal is to enable you to explore yourself so you become more confident and assertive. You will be empowered to make changes that lead to greater satisfaction in your life.
(559) 527-5929 View (559) 527-5929
Photo of Brenda Zarate, MS, LMFT, Marriage & Family Therapist
Brenda Zarate
Marriage & Family Therapist, MS, LMFT
Verified Verified
3 Endorsed
Fresno, CA 93720
I truly believe each individual is the expert on their own life and trust that through treatment, they will learn more about themselves and gain confidence as they contribute in their healing process. My vision for therapy is to aid each client in gaining awareness about who they are and how they came to be with an empathic and client centered approach.
I truly believe each individual is the expert on their own life and trust that through treatment, they will learn more about themselves and gain confidence as they contribute in their healing process. My vision for therapy is to aid each client in gaining awareness about who they are and how they came to be with an empathic and client centered approach.
(559) 423-7461 View (559) 423-7461
Photo of Desirae Spignor, LCSW, Clinical Social Work/Therapist
Desirae Spignor
Clinical Social Work/Therapist, LCSW
Verified Verified
Fresno, CA 93722
Hello, my name is Desirae Spignor. I am a Licensed Clinical Social Worker. My therapeutic approach is eclectic, integrating my education and lived experience into my practice. In my experience trauma (historical, environmental, interpersonal, etc.) has been the root cause of most behavioral health and even some medical issues. If we work on ways to alleviate the impacts of trauma(s) on our lives it'll directly impact our overall wellness. This is why I've spent my time as a Behavioral Health Specialist focused on learning/unlearning about trauma and how impacts us.
Hello, my name is Desirae Spignor. I am a Licensed Clinical Social Worker. My therapeutic approach is eclectic, integrating my education and lived experience into my practice. In my experience trauma (historical, environmental, interpersonal, etc.) has been the root cause of most behavioral health and even some medical issues. If we work on ways to alleviate the impacts of trauma(s) on our lives it'll directly impact our overall wellness. This is why I've spent my time as a Behavioral Health Specialist focused on learning/unlearning about trauma and how impacts us.
(559) 245-1921 View (559) 245-1921
Photo of Jessica L. Criner - RESET Trauma & Family Counseling Center, MS, LMFT, Marriage & Family Therapist
RESET Trauma & Family Counseling Center
Marriage & Family Therapist, MS, LMFT
Verified Verified
2 Endorsed
Fresno, CA 93729  (Online Only)
Book with me now by clicking on my website! There are seasons in life that are very unpredictable, 2020 for example! If you are finding that the last few months, weeks, maybe even years have been full of overwhelming amounts of change, transition and uncertainty, your are not alone. I understand the uncertainty of life can cause depression, anxiety, and unresolved traumas to arise. My goal is to assist you with getting to the heart of the issues you are enduring, while embracing the resiliency and strength it took for you to make it this far. Emotional healing and relief is near.
Book with me now by clicking on my website! There are seasons in life that are very unpredictable, 2020 for example! If you are finding that the last few months, weeks, maybe even years have been full of overwhelming amounts of change, transition and uncertainty, your are not alone. I understand the uncertainty of life can cause depression, anxiety, and unresolved traumas to arise. My goal is to assist you with getting to the heart of the issues you are enduring, while embracing the resiliency and strength it took for you to make it this far. Emotional healing and relief is near.
(209) 391-2420 View (209) 391-2420
Photo of Angela A Ybarra, LMFT, Marriage & Family Therapist
Angela A Ybarra
Marriage & Family Therapist, LMFT
Verified Verified
Fresno, CA 93728  (Online Only)
Waitlist for new clients
Welcome! I am a trauma attuned and informed therapist who provides individual therapy to those struggling with symptoms of trauma, depression and anxiety. I also provide preparation, facilitation of psilocybin and ketamine journeys and integration for those seeking or who have experienced a psychedelic experience. Disclamer-I do not provide psychoactive or illicit substances, nor do I provide referrals to underground or illegal psychedelic services. For more information about me please visit angelaybarraoregonpsilocybin.squarespace.com
Welcome! I am a trauma attuned and informed therapist who provides individual therapy to those struggling with symptoms of trauma, depression and anxiety. I also provide preparation, facilitation of psilocybin and ketamine journeys and integration for those seeking or who have experienced a psychedelic experience. Disclamer-I do not provide psychoactive or illicit substances, nor do I provide referrals to underground or illegal psychedelic services. For more information about me please visit angelaybarraoregonpsilocybin.squarespace.com
(559) 461-3038 View (559) 461-3038
Photo of Nicole Lapointe, LCSW, Clinical Social Work/Therapist
Nicole Lapointe
Clinical Social Work/Therapist, LCSW
Verified Verified
Fresno, CA 93722
Hi there, I'm Nicole! Therapy is an opportunity for self-discovery, empowerment, and healing. I work with various issues, including depression, anxiety, parenting, life transitions, and stress. I specialize in HIV/STD support, women's health, and older adults/ seniors. My goal is to help you recognize that you have all the tools and strength to develop and manage all of your challenges. I will work alongside you at your pace, providing a safe space to feel heard, understood, and supported in your growth.
Hi there, I'm Nicole! Therapy is an opportunity for self-discovery, empowerment, and healing. I work with various issues, including depression, anxiety, parenting, life transitions, and stress. I specialize in HIV/STD support, women's health, and older adults/ seniors. My goal is to help you recognize that you have all the tools and strength to develop and manage all of your challenges. I will work alongside you at your pace, providing a safe space to feel heard, understood, and supported in your growth.
(559) 551-3456 View (559) 551-3456
Photo of Savannah Dragomanovich, MS, LMFT, Marriage & Family Therapist
Savannah Dragomanovich
Marriage & Family Therapist, MS, LMFT
Verified Verified
Fresno, CA 93704
My primary goal is to empower you, I truly believe that you are the expert on you! Our first few sessions will be focusing on making sure we really get to know each other, as well as share the same language when it comes to your symptoms, experiences, and goals. From there on out we will jump in to the work together! I primarily work with young adults entering college or experiencing life for the first time, couples where neurodivergence is present, and individuals trying to find what it means to be them, whether that be their gender, sexuality, neurodiversity, etc.
My primary goal is to empower you, I truly believe that you are the expert on you! Our first few sessions will be focusing on making sure we really get to know each other, as well as share the same language when it comes to your symptoms, experiences, and goals. From there on out we will jump in to the work together! I primarily work with young adults entering college or experiencing life for the first time, couples where neurodivergence is present, and individuals trying to find what it means to be them, whether that be their gender, sexuality, neurodiversity, etc.
(559) 785-3244 View (559) 785-3244
Photo of Roopa Cantu, LCSW, Clinical Social Work/Therapist
Roopa Cantu
Clinical Social Work/Therapist, LCSW
Verified Verified
Fresno, CA 93722  (Online Only)
My trajectory as a person and professional has been engaging, enlightening, and adventurous. My career has been incredibly diverse and fulfilling, from labor and community organizing to counseling and psychotherapy. I seek to provide supportive and individualized clinical supervision and psychotherapy services to you, whatever your need might be. I feel deep empathy and connection to all people who have also been on the journey of self-development and growth; this encompasses fellow culturally diverse recovering alcoholics, members of 12-step programs, and beneficiaries of mental health treatment including from disordered eating.
My trajectory as a person and professional has been engaging, enlightening, and adventurous. My career has been incredibly diverse and fulfilling, from labor and community organizing to counseling and psychotherapy. I seek to provide supportive and individualized clinical supervision and psychotherapy services to you, whatever your need might be. I feel deep empathy and connection to all people who have also been on the journey of self-development and growth; this encompasses fellow culturally diverse recovering alcoholics, members of 12-step programs, and beneficiaries of mental health treatment including from disordered eating.
(559) 529-9498 View (559) 529-9498

How does your Therapist compare?

Number of Therapists in Fresno, CA

800+

Average cost per session

$145

Therapists in Fresno, CA who prioritize treating:

91% Anxiety
89% Depression
72% Coping Skills
71% Self Esteem
69% Relationship Issues
67% Stress
66% Trauma and PTSD

Average years in practice

10 Years

Top 3 insurances accepted

76% Aetna
71% UnitedHealthcare UHC | UBH
70% Cigna and Evernorth

How Therapists in Fresno, CA see their clients

81% In Person and Online
19% Online Only

Gender breakdown

80% Female
19% Male
1% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Fresno?

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.